The display copy of the Quality Payment Program proposed rule was released in June, and you can think of this rule as a companion to the Medicare Physician Fee Schedule that typically comes out with the OPPS rule. That means both rules need to be read, understood, and, ideally, commented on by providers.
Carolinas Healthcare System agreed to pay $6.5 million to settle allegations of a years-long practice of upcoding urine drug tests, the Office of Inspector General announced June 30.
The new ICD-10-CM codes for FY 2018, effective October 1, represent significant changes in our documentation and coding practices. Please consider some of these changes and determine whether your documentation or billing habits require an update.
The release of the Quality Payment Program proposed rule introduced virtual groups as a way to reduce burden on small practices and clinicians. While the MACRA legislation laid out the initial concept of virtual groups, this proposed rule revealed many more details about how virtual groups will function.
CMS has spoken repeatedly of easing the burden for providers this spring, and the agency’s Quality Payment Program (QPP) proposed rule released June 20 attempts to do that for small practices and other clinicians.
CMS issued SE1609 to clarify long-standing policy concerning external infusion pumps. Apparently, both freestanding physician offices and outpatient hospital departments were treating external pumps as an item of durable medical equipment, even when the physician or hospital department set up the pump on the patient, supplied the drug, and programmed the infusion rate and dose into the pump.
The 2017 calendar year marks the beginning of a new approach to physician payment through the Quality Payment Program (QPP), an initiative created by the Medicare Access and CHIP Reauthorization Act to revise the physician payment system previously updated through the Sustainable Growth Rate.
When CMS introduced Hierarchical Condition Categories (HCC) with risk-adjusted scores, Ochsner Health System began efforts to educate providers and improve documentation across its many facilities.
A recent Coding Clinic has garnered a lot of questions on inpatient obstetrics coding. While coders were originally taught to use multiple codes for the repair of a third- or fourth-degree perineal laceration, Coding Clinic, First Quarter 2016, states that you don’t use multiple codes for third- and fourth-degree tears, because you need to code to the “deepest layer.” New guidance has further confused the issue.
In ICD-10-CM, defining, diagnosing, and documenting the various forms of altered mental status and their underlying causes remains an ongoing challenge for physicians and their facilities.
