Establishing an outpatient CDI program can have substantial benefits. Recently, an outpatient CDI review project demonstrated there were many documentation improvement opportunities at a large family practice/internal medicine physician clinic.
Along with quality measure removals in the 2018 OPPS and MPFS final rules, CMS has continued to propose additional removals in the 2019 proposed rules. In addition, the agency is proposing to add to its ability to remove quality measures in the future.
Inappropriate use of nonemergency ambulance transport cost Medicare $8.7 million in overpayments, according to a recent Office of Inspector General (OIG) report.
Back in January, I wrote an article regarding E/M codes and the need for changes to the 1995 and 1997 E/M documentation guidelines. In that article, I suggested making E/M codes for office visits solely time-based to simplify the reporting of these very subjective codes. Little did I know that this is what CMS would propose months later.
The National Center for Health Statistics recently released the 2019 ICD-10-CM Official Guidelines for Coding and Reporting, effective October 1, which include updated language and added specificity for classifying diagnoses.
CMS did not propose any new comprehensive APCs (C-APC) last year, taking a rare year off, but it did introduced three new C-APCs in the 2019 OPPS proposed rule, released in late July.
CMS’ 2019 OPPS proposed rule continues the agency’s efforts to enforce site-neutral payments and reduce drug payments by introducing policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expanding last year’s payment reductions for drugs purchased under the 340B discount pricing program by nonexcepted PBDs.
