November 4, 2020
News & Insights

CMS’ Fourth COVID-19 Interim Final Rule with Comment Period includes additional payment for new COVID-19 treatments, price transparency requirements for COVID-19 diagnostic tests, and coverage for potential vaccines among other provisions.

November 1, 2020
Briefings on APCs

Valerie A. Rinkle, MPA, CHRI, writes about Medicare guidance on and updated payment policies for COVID-19 testing, vaccines, and telehealth services.

November 2, 2020
News & Insights

Q: How does case-mix index (CMI) impact hospital finances? What should revenue integrity staff look for when conducting CMI analyses?

October 28, 2020
News & Insights

The full U.S Court of Appeals declined to reconsider two recent decisions that upheld CMS’ cuts to reimbursement for certain off-campus provider-based department (PBD) visits and drugs acquired under the 340B program, the American Hospital Association (AHA) announced October 19.

October 26, 2020
News & Insights

Physician and non-physician practitioners may benefit from reviewing bundling rules for emergency department visit services billed on the same date as critical care, according to the October 2020 Medicare Quarterly Compliance Newsletter.

October 26, 2020
News & Insights

Q: Starting January 1, 2021, CMS will be lowering reimbursement for high throughput novel coronavirus (COVID-19) diagnostic tests from $100 to $75. I understand that if certain requirements are met labs will be eligible to bill for a $25 add on code. How can we meet the requirements for the add on code?

October 21, 2020
News & Insights

CMS will reduce payments to laboratories that take longer than two days to complete high-throughput COVID-19 diagnostic tests effective January 1, 2021, according to an October 15 press release.

October 1, 2020
Briefings on APCs

Outpatient coders should be familiar with CPT reporting for knee surgeries based on information in the operative note. This article reviews the anatomy of the knee joint and CPT coding for arthroscopic and reconstructive procedures used to visualize and treat common knee conditions.

October 19, 2020
News & Insights

CMS added 11 new services to the list of telehealth services on October 14 that it will pay for during the novel coronavirus (COVID-19) public health emergency.

October 14, 2020
News & Insights

CMS extended the timeline for organizations to repay payments received under its Accelerated and Advance Payment program, according to a fact sheet released October 8.

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