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.
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
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.
Community Hospital in Munster, Indiana, is disputing an Office of Inspector General (OIG) report that found DRG assignment errors and incorrect inpatient rehabilitation facility (IRF) claims, resulting in an projected $22,051,602 in overpayments.
CMS released Transmittal 4246 on February 22, revising language in Chapter 13 of the Medicare Claims Processing Manual regarding the billing of E/M codes on the same date of service as superficial radiation treatment delivery.
CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.
In 2018, most organizations held the line on coder productivity, according to the results of sister publication HIM Briefings’ 2018 coding productivity survey.
A retrospective study recently published in Pediatrics found that a statewide administrative database containing billing and coding information for newborn discharges accurately captured risk factors and outcomes for perinatal patients. This suggests that administrative databases may be effectively used to analyze performance metrics and accelerate data quality improvement efforts locally.
The improper payment rate for routine venipuncture lab tests was 16.3% in 2018, representing more than $20 million, and medical necessity errors accounted 98.9% of the improper payments, according to CMS.
