The Most Favored Nation (MFN) model interim final rule should be withdrawn immediately, the American Hospital Association (AHA) said in a January 25 letter to CMS.
The American Medical Association (AMA) recently added a new CPT code that will be used to report a COVID-19 vaccine candidate under development by Janssen Pharmaceutica, a division of Johnson & Johnson.
Hospital coding for pregnancy-related services requires a detailed understanding of the CPT® global obstetric (OB) package and ICD-10-CM coding guidelines for maternal care management. This article details hospital coding for pregnancy and delivery complications and procedures used to treat them.
The American Medical Association (AMA) recently released a free tool to help clinical staff determine appropriate CPT® and HCPCS Level II coding for COVID-19 vaccines and vaccine administration.
UnitedHealthcare (UHC) is suspending certain prior authorization requirements for in-network hospitals and skilled nursing facilities through January 31.
Section 1862 (l) and Section 1869 (f)(2)(B) of the Social Security Act (the Act) sets forth general procedures to develop and evaluate Medicare coverage determinations that are either adopted nationally by CMS or created and applied locally by a Medicare Administrative Contractor (MAC) within the MAC’s own jurisdictional boundaries.
CMS recently released MLN Matters MM12126, which summarizes 2021 CPT and HCPCS Level II code updates for Part B outpatient therapy services. The changes permanently expand Medicare coverage of certain communication technology-based (CTB) services, including virtual check-ins and telephone assessments.
The Office of Inspector General (OIG) will be conducting a second round of audits to determine whether acute care hospitals are being inappropriately reimbursed for outpatient services provided to inpatients, according to a recent update to the OIG’s Work Plan.
