The Medicine section of the CPT Manual includes codes for a variety of services including acupuncture, vaccinations, and behavioral health assessments and is divided into 33 subsections that can make it challenging to navigate.
CMS put hospitals on track to face expanded price transparency requirements with a final rule released in November 2019. Take a closer look at how price transparency is set to change and what hospitals need to do.
On January 28, CMS published a revised Medicare Claims Processing Transmittal 4501 and the associated MLN Matters 11501 regarding the 2020 update to the therapy code list to change a statement about how two new biofeedback codes will be paid.
CMS is expanding Medicare coverage of next-generation sequencing (NGS) to diagnose certain types of ovarian and breast cancer, according to a January 27 decision memo.
Q: How do we bill for services when our utilization review (UR) team determines postdischarge that an inpatient admission was not medically necessary? Are these services billed as outpatient or inpatient?
Several Medicare claims for trastuzumab mutli-dose vials billed over the last three years failed to comply with Medicare requirements in part due to the improper application of modifier -JW, according to a study reported in the January 2020 Medicare Quarterly Provider Compliance Newsletter.
The 340B drug discount program does not appear to incentivize hospitals to use more expensive drugs, according a Medicare Payment Advisory Commission (MedPAC) report presented at its January 17 meeting.
One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.
