Over 20% of commercially insured adults who underwent a common in-network surgical procedure between January 2012 and September 2017 received surprise charges for the episode from out-of-network clinicians, according to a recent study published in JAMA.
Providers need to clean up coding for electro-acupuncture devices, according to CMS. Claims submitted with HCPCS code L8679 will be subject to additional scrutiny to ensure they're correct.
The Patient-Driven Payment Model has shaken up skilled nursing facility (SNF) billing and coding. Learn the ins and outs of PDPM and how it will affect your organization.
The Medicine section of the CPT Manual includes codes for a variety of services including acupuncture, vaccinations, and behavioral health assessments and is divided into 33 subsections that can make it challenging to navigate.
On January 28, CMS published a revised Medicare Claims Processing Transmittal 4501 and the associated MLN Matters 11501 regarding the 2020 update to the therapy code list to change a statement about how two new biofeedback codes will be paid.
Several Medicare claims for trastuzumab mutli-dose vials billed over the last three years failed to comply with Medicare requirements in part due to the improper application of modifier -JW, according to a study reported in the January 2020 Medicare Quarterly Provider Compliance Newsletter.
One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.
The American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) recently filed a lawsuit against the Department of Health and Human Services (HHS) for continuing to reduce payments for hospital outpatient services provided in grandfathered, off-campus provider-based departments (PBD) in the fiscal year 2020 OPPS final rule.
Whether coders are on-site or remote, managers can use a variety of techniques to foster communication and support a professional workspace. Use these tips to strengthen your coding team.
Take a look at some common questions asked about MS-DRG optimization and review how inpatient coding and documentation plays a significant role in the process. Learning the ins and outs of this process will ensure that your facility remains educated and compliant.
