The 2018 OPPS proposed rule includes potential changes to 340B drug discount payments, the inpatient-only list, packaging for low-level drug administration services, and more.
In a move that has been anticipated for a few years, CMS issued a proposal in the 2018 OPPS proposed rule to expand packaging policies to include low-level drug administration services.
Resolving claims returned with National Correct Coding Initiative edits or Medically Unlikely Edits can be a time-consuming process. Organizations need processes to promote best practices and keep appeals on track, as well as coding and billing policies that address common front-end problems that lead to these edits.
The specificity of ICD-10 ushered in a stronger focus on clinical coding audits. From internal reviews to external coding audits, healthcare organizations nationwide are revisiting tried-and-true audit practices with ICD-10 coding quality in mind.
CMS released the fiscal year (FY) 2018 IPPS final rule August 2, updating Medicare payment and polices for patients discharged from hospitals from October 1, 2017, to September 30, 2018.
CMS updated its website for the Quality Payment Program recently with new information clarifying which clinicians will have “special status” and may be exempt from submitting data this year.
The new ICD-10-CM codes for FY 2018, effective October 1, represent significant changes in our documentation and coding practices. In follow-up to last month’s column, let’s discuss additional new codes and their potential impact upon your diagnostic decision-making and documentation.
Whether it is the CPT Manual or Chapter 12 of the Medicare Claims Processing Manual, the definition of a “new patient” is the same for physicians and nonphysician practitioners billing. But that doesn't mean coding and billing for E/M services is clear cut.
CMS proposed a handful of changes to the inpatient-only list in the 2018 OPPS proposed rule, including the removal of total knee replacement procedures from the list despite receiving mixed feedback on that idea last year.
As CMS and third-party payers have looked for ways to treat patients in the outpatient setting and reduce inpatient volumes, CMS has used the 2-midnight rule, in addition to other methods, to treat patients as outpatients or in observation whenever possible.
