March 1, 2019
Briefings on APCs

Coding for knee arthroscopies can be challenging, especially when procedures are performed in multiple compartments of the same knee. Read about anatomy and coding details required to accurately report these procedures.

March 18, 2019
News & Insights

The American Medical Association’s (AMA) CPT Editorial Panel approved significant changes to E/M reporting guidelines, including the deletion of a visit code, creation of new criteria for the selection of a visit level, and overhaul of the medical decision-making (MDM) documentation guidelines at a meeting held in February, to align with recent E/M changes finalized by CMS.

March 13, 2019
News & Insights

A proposed rule from HHS’ Office of the National Coordinator for Health Information Technology (ONC) could mandate the publication of prices negotiated between payer and provider organizations as well as detailed information about Medicare reimbursement, DRG prices, and bundled prices.

March 1, 2019
Briefings on APCs

Many outpatient CDI professionals stepped into their roles blind—not knowing where to begin or how to tell if they were successful. However, as programs mature, they need to be able to track their progress for a number of reasons, including focusing physician education and justifying continued funding from organizational leadership.

March 11, 2019
News & Insights

CMS recently pushed back the start date for Medicare Administrative Contractors (MAC) to expand coverage terms for patients in need of an implantable cardiac defibrillator (ICD) by one month. The agency released Transmittal 213 on February 15, announcing a delayed implementation date of March 26.

March 6, 2019
News & Insights

Accountable care organizations that have switched tracks to take on downside risk tend to be larger, located in urban areas, and more successful on financial metrics, according to a recent report. However, the report did not find any significant relationship between switching to downside risk tracks and improvement on quality or public health metrics.

March 13, 2019
HIM Briefings

Accurate and detailed medical documentation is critical for patient safety and to ensure payment for services rendered. Use these tips to keep clinical trials documentation compliant.

March 1, 2019
Briefings on APCs

In the 2018 OPPS final rule, CMS removed total knee arthroplasty (TKA) from the inpatient-only (IPO) list effective January 1, 2018. Although some guidance was provided at the time, providers and physicians alike were left confused with a significant number of questions regarding documentation and inpatient status

March 4, 2019
News & Insights

CMS recently posted answers in a set of Frequently Asked Questions (FAQ) about the 2019 Merit-based Incentive Payment System (MIPS) payment adjustment. The agency outlines the types of services subject to a 2019 MIPS payment adjustment, how these services are reflected on remittance advice (RA) documents, and anticipated payment corrections to claims billed for Part B drugs.

March 4, 2019
News & Insights

Q: What is the recommended method for modeling reimbursement for contracts based on a percentage of Medicare rates?

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