Most inpatient rehabilitation facility stays might not meet Medicare coverage or documentation requirements and compliance could be improved through a preauthorization process, according to a recent Office of Inspector General report.
As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption.
In the 2019 OPPS final rule, released Friday, November 2, CMS implemented several site-neutral payment policies, though the agency did delay or shelve other proposals due to stakeholder feedback.
CMS is proposing to expand Medicare Advantage (MA) telehealth benefits and to increase auditing and recovery of overpayments made to MA plans, according to a proposed rule released October 26.
Developing an outpatient CDI program isn't just about metrics--departments needs to consider how to engage providers and interact with other teams to be truly effective.
It's been more than three years since CMS introduced a subset of modifiers it wants providers to report instead of modifier -59 (distinct procedural service), but they're still optional as barely any new guidance has been released.
Millions of medical records are sent to insurance companies every year by hospital and health system business office personnel to expedite claims payment, respond to payer audits, or fulfill other payer denial requests for information. And any time medical records are handled, HIPAA concerns come into play.
