The Centers for Disease Control and Prevention (CDC) updated its clinical guidance for diagnosing and treating electronic cigarette- or vaping-associated lung injuries (EVALI) in light of the approaching 2019-2020 flu season.
Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a November 1 report from the Office of Inspector General (OIG).
Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use ICD-10-CM code Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e., C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?
CMS recently announced that the Medicare Fee for Service (FFS) improper payment rate is at its lowest level since fiscal year (FY) 2010. The FY 2019 improper payment rate is 7.25%, according to the U.S. Department of Health and Human Services’ (HHS) annual Agency Financial Report.
Medicare overpaid providers $640,452 for chronic care management (CCM) services and may have overpaid outpatient facilities an additional $1.2 million for CCM, according to an Office of Inspector General (OIG) report released November 7.
The fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, released shortly after the FY 2020 ICD-10-CM code release, provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Coders should take time to review these changes that were implemented October 1.
In today’s virtual environment, with its focus on flexible schedules, organizing the coding function requires consideration of time zones, team member skills, volume of work, and claim-processing schedules.
The Patient-Driven Payment Model (PDPM) has so many nuances that can impact reimbursement that it is near impossible for SNFs to consider and capitalize on them all. Check your processes and procedures to ensure you’re taking advantage of or protecting against the following aspects of PDPM.
