The 2020 update to the CPT Manual includes extensive updates to cardiovascular codes, including new codes for pericardiocentesis and pericardial drainage, aortic grafting, and endovascular repair procedures.
In an effort to increase the medically appropriate use of transitional care management (TCM) services, CMS increased payment and removed billing restrictions for TCM services, as outlined in the 2020 Medicare Physician Fee Schedule (MPFS) final rule.
CMS recently published Transmittal 332 to inform Medicare administrative contractors and providers of new billing considerations, effective January 1, 2020, for medication-assisted treatments provided by opioid treatment programs.
Northwest Medical Center in Arizona received $201,624 from Medicare for incorrectly billed inpatient and outpatient services based on a sample of claims, according to a report released by the Office of Inspector General (OIG) on December 3. The OIG estimates that, based on the sample, the hospital may have received at least $1.2 million in overpayments during the audit period of January 1, 2016 through December 31, 2017.
Carolinas Hospital in Florence, South Carolina, received $431,757 in Medicare overpayments for incorrectly billed inpatient and outpatient services, according to an Office of Inspector General (OIG) audit report released November 26. Based on the sample, the OIG estimates the hospital may have received at least $3.4 million in overpayments.
In the 2020 Medicare Physician Fee Schedule (MPFS) final rule, CMS put a stamp of approval on its previous proposals to overhaul how medical practices will report office and outpatient E/M services in 2021.
The Centers for Disease Control and Prevention (CDC) updated its clinical guidance for diagnosing and treating electronic cigarette- or vaping-associated lung injuries (EVALI) in light of the approaching 2019-2020 flu season.
Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use ICD-10-CM code Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e., C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?
The 2020 IPPS final rule is out, and CMS has opted not to allow organizations to code homelessness as a complication or comorbidity (CC) under ICD-10-CM code Z59.0.
The fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, released shortly after the FY 2020 ICD-10-CM code release, provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Coders should take time to review these changes that were implemented October 1.
