February 11, 2019
News & Insights

Q: How is a standard paper remittance (SPR) different from an electronic remittance advice (ERA)?

February 1, 2019
Briefings on APCs

Modifier -JW is used to describe drug amounts that are discarded and not administered to any patient. This does not reduce the payment for the drugs, so this is an informational modifier, but it is a mandatory modifier.

January 30, 2019
News & Insights

Mandatory participation in Medicare bundled payment programs may yield better results, the U.S. Government Accountability Office (GAO) said in a report released January 22.

January 28, 2019
News & Insights

Thirty-eight hospitals filed a lawsuit against the U.S. Department of Health and Human Services (HHS) on January 18, alleging that that HHS Secretary Alex Azar overstepped his authority when he finalized an OPPS policy that cuts Medicare payment rates to off-campus, provider-based departments (PBD).

January 21, 2019
News & Insights

Increased access to urgent care centers (UCC) may decrease the number of patients who seek treatment for low-acuity conditions in hospital emergency departments (ED), according to findings from a retrospective study recently published in the American Journal of Emergency Medicine.

January 1, 2019
Briefings on APCs

Establishing an outpatient CDI program can have substantial benefits. Recently, an outpatient CDI review project demonstrated there were many documentation improvement opportunities at a large family practice/internal medicine physician clinic.

January 14, 2019
News & Insights

Q: How can I identify a suspended claim? Is there anything that can be done to move a suspended claim forward?

January 14, 2019
News & Insights

Findings from a computational health informatics study recently published in Medical Care Research and Review suggest that provider connectedness is associated with reduced 30-day readmission rates for heart failure patients following hospital discharge.

January 9, 2019
News & Insights

CMS ramped up risk-sharing for accountable care organizations (ACO) in a final rule published December 31, 2018. The final rule makes changes to the Medicare Shared Savings Program and will reduce the amount of time ACOs can stay in one-sided risk models.

January 1, 2019
Briefings on APCs

The 2019 CPT code update includes 19 code additions and three revisions to the cardiovascular section of the CPT Manual. These changes reflect advances in surgical treatment for cardiovascular conditions such as heart failure and aortic stenosis.

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