In a series of press releases, CMS announced certain public health emergency policies are in effect for the parts of Texas, Louisiana, and Florida hit by Hurricanes Harvey and Irma.
The new ICD-10-CM codes for FY 2018, effective October 1, 2017, represent significant changes in some of our documentation and coding practices. Review the changes to the FY 2018 ICD-10-CM Official Guidelines for Coding and Reporting (the Guidelines), which must be embraced if our documentation, coding, and billing is to withstand compliance scrutiny from outside auditors and accountability agents.
Many HIM directors and coding managers say it takes all three to recruit high-quality, experienced medical record coders post-ICD-10. While coder shortages are nowhere near what they were in ICD-9, new challenges have emerged for HIM staffing.
A successful outpatient CDI program will be invaluable to an organization, but without a focus and plan the program can become overwhelmed and ineffective. HIM and CDI need to work closely together to identify the greatest areas of opportunity in the outpatient setting and ensure that goals are aligned throughout the continuum of care.
You may find significant changes to E/M reporting in the near future, including a pivot away from two key elements — history and physical exam — that largely determine a given level of service for your most common patient encounters.
Two bundled payment programs could be canceled before they begin, and the scope of a third will be significantly limited if a proposed rule released by CMS August 17 is finalized.
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.
