June 3, 2019
News & Insights

CMS released the fiscal year (FY) 2020 ICD-10-PCS changes on Friday, May 31, which include two code revisions, 734 additions, and 2,056 invalidations.

June 5, 2019
HIM Briefings

Put CMS’ proposed changes in perspective to see the bigger picture. Comments are due June 24, so hospitals will need to conduct a careful analysis to determine the impact of the proposed changes and submit specific feedback.

May 29, 2019
News & Insights

Wide variation in the cost of common diagnostic tests significantly contributes to healthcare cost inflation and standardizing prices could save billions annually, according to a recent UnitedHealth report.

May 22, 2019
News & Insights

The National Association of Healthcare Revenue Integrity (NAHRI) is pleased to announce Revenue Integrity Week, a national week of recognition for revenue integrity professionals, to be held June 3–7. This year’s theme is Scale New Heights: Elevate Your Profession and Career.

May 22, 2019
News & Insights

CMS modified its proposal to expand prior authorization and step therapy to protected classes of drugs for Part D and Medicare Advantage beneficiaries, according to a final rule released May 16.

May 20, 2019
News & Insights

Q: Does this new policy apply to traditional Medicare only or does it also apply to Medicare Advantage?

May 1, 2019
Briefings on APCs

The most commonly reported CPT codes are getting a much-needed makeover. Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, writes about E/M code changes implemented this year and changes for implementation over the next two years.

May 1, 2019
Briefings on APCs

Healthcare organizations and providers are experiencing a shift in outpatient reimbursement: from fee-for-service to Alternative Payment Models and value-based reimbursement based on quality outcomes.

May 13, 2019
News & Insights

U.S. District Judge Rudolph Contreras last week reaffirmed that the U.S. Department of Health and Human Services (HHS) exceeded its authority when it made 2018 payment cuts to outpatient hospitals for certain drugs purchased through the 340B drug pricing program, and extended the ruling to 2019 payment cuts.

May 13, 2019
News & Insights

Q: What is the deadline for refunding Medicare overpayments?

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