CMS developed the National Correct Coding Initiative (NCCI) to control improper coding and potentially inappropriate payment of Part B services. Review NCCI basics to ensure compliance with the latest coding policies.
With reimbursement gains whittled down by CMS' attempt to remedy unlawful cuts to 340B drug payments, complying with updated Outpatient Prospective Payment System (OPPS) policies is key to protecting reimbursement. Take a closer look at CMS' latest policies and ensure your organization is in compliance.
Uncommon MS-DRGs can be a red flag to auditors even when the encounter is correctly assigned to one. Use these tips to ensure coding and documentation supports the use of these MS-DRGs.
Clinical validity denials occur when there is a lack of clinical evidence in the patient chart to support a billed diagnosis. Learn more about common reasons for these denials and how to defend against them.
The 2023 Medicare Physician Fee Schedule ushered in a slew of changes to payment rates, coding guidelines, and telehealth coverage. Review key changes to ensure your organization is in compliance.
As of November 16, the CPT Editorial Panel has approved 56 Category I codes for severe acute respiratory syndrome coronavirus 2 vaccines and immunization administration. In this article, Kimberly Lee, M.Ed., RHIA, CCS-P, addresses some of the new COVID-19 product and administration codes.
The 2023 CPT code update introduced an option for reporting nasal valve collapse repairs, as well as revisions to certain injection codes to include imaging guidance.
With reimbursement gains whittled down by CMS' attempt to remedy unlawful cuts to 340B drug payments, complying with updated Outpatient Prospective Payment System (OPPS) policies is key to protecting reimbursement. Take a closer look at CMS' latest policies and ensure your organization is in compliance.
Vaccine administration is a routine part of healthcare services, so it's important to know how to correctly code for them. Brush up on coding guidance for vaccines to ensure you're up to speed on the latest rules.
Determining the principal diagnosis is a basic function of CDI review and critical to prioritizing subsequent reviews, but is often a challenging process and requires careful consideration and interpretation of regulatory guidance and collaboration with coding professionals. Use these tips to ensure your CDI and coding teams are on the same page.
