June 4, 2018

CMS introduced packaging guidance for total knee arthroplasty procedures paid under the OPPS and billed in conjunction with anesthesia administration as part of the July 2018 quarterly update to the integrated outpatient code editor.

May 1, 2018
Briefings on APCs

CMS recently released MLN Matters SE18001 to provide healthcare practitioners with instructions and coding guidance for specimen validity when performed and billed in combination with drug testing. The article was issued to remind laboratories and other providers performing urine drug testing that specimen validity testing (SVT) is not separately billable.

May 9, 2018
News & Insights

CMS recently clarified the use of modifier -KX (requirements specified in the medical policy have been met) in response to an Office of Inspector General report that identified conflicting guidance that resulted in $4.6 million in improper payments.

May 1, 2018
Briefings on APCs

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), it is estimated that more than half a million people in the U.S. have Crohn’s disease. For unknown reasons, the disease has become more widespread in both the U.S. and other parts of the world.

May 30, 2018
HIM Briefings

The brain is the most complex component of the central nervous system, consisting of approximately 100 billion neurons that communicate via an exponential number of synapses. Coding for the brain can seem almost as complex. Brush up on ICD-10-CM/PCS coding for the brain.

May 16, 2018
HIM Briefings

Creating and using performance standards benefits HIM directors and the many functions they oversee. But with such a wide range of tasks falling under the HIM umbrella, it can be challenging to set practical standards that yield meaningful results. Follow these tips to get the most of out of your department’s standards.

May 2, 2018
HIM Briefings

Correct, complete documentation is the foundation of a sound medical record and compliant reimbursement, but getting that foundation in place can be challenging. Clinicians are juggling critical tasks in a high-stress situation, and administrative burden of electronic documentation and the disconnect that results from spending more time looking at a screen than a patient are often cited as the primary factors in physician burnout. Enter the medical scribe.

May 1, 2018
Briefings on APCs

A coding audit may be conducted by internal staff or external entities, typically representing the insurers paying for the care. When planning to implement a coding auditing program, the type of reviews, focus areas, and review frequency must all be taken into consideration.

April 25, 2018
HIM Briefings

Medicare billing edits such as National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) must be resolved at their root cause so that they do not continue to occur on claim

April 25, 2018

CMS released the fiscal year (FY) 2019 IPPS proposed rule on Tuesday, April 24, with an overhaul of the Meaningful Use program and significant reductions to reporting requirements for quality initiatives, along with updates to payment rates.

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