The April 2019 OPPS quarterly update reassigned specific skin substitute products from the low-cost group to the high-cost group, and clarified billing and reporting for chimeric antigen receptor T-cell (CAR-T) therapy procedures performed in the outpatient setting.
Coding for knee arthroscopies can be challenging, especially when procedures are performed in multiple compartments of the same knee. Read about anatomy and coding details required to accurately report these procedures.
The American Medical Association’s (AMA) CPT Editorial Panel approved significant changes to E/M reporting guidelines, including the deletion of a visit code, creation of new criteria for the selection of a visit level, and overhaul of the medical decision-making (MDM) documentation guidelines at a meeting held in February, to align with recent E/M changes finalized by CMS.
Many outpatient CDI professionals stepped into their roles blind—not knowing where to begin or how to tell if they were successful. However, as programs mature, they need to be able to track their progress for a number of reasons, including focusing physician education and justifying continued funding from organizational leadership.
CMS recently pushed back the start date for Medicare Administrative Contractors (MAC) to expand coverage terms for patients in need of an implantable cardiac defibrillator (ICD) by one month. The agency released Transmittal 213 on February 15, announcing a delayed implementation date of March 26.
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
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.
