The federal government has prioritized giving more patients the ability to get healthcare in their homes. In pursuit of this goal, it recently granted an extension that will allow states more time to use American Rescue Plan Act of 2021 funds to provide additional long-term services and support to beneficiaries.
Modifier -JW is used to describe drug amounts that are discarded and not administered to any patient. Refresh your knowledge of this modifier with coding tips and example scenarios.
OCR released a report on audits it conducted. It found that most CEs failed to meet the requirements for selected provisions in the audit. One of the first steps to improving is learning more about audits and assessments, which are trouble spots for entities.
Coding audits are essential to ensuring compliance but without defined processes these audits may lack focus and consistency. Understand how to create strong processes for targeted, consistent, and accurate coding audits.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, unpacks local and national medical necessity standards and best practices for avoiding denials due to inadequate documentation.
Among the proposed changes, many of which affect quality and data reporting programs, are proposed changes to claims data used for rate setting, a delay of the three way split criteria for Medicare Severity Diagnosis-Related Groups (MS-DRG), and more. Understand major proposals and their potential impact and how to provide feedback to CMS.
As part of our continuing series, BOH caught up with Rebecca Herold, CDPSE, FIP, CISSP, CIPM, CIPP/US, CIPT, CISM, CISA, FLMI, to ask the privacy expert HIPAA compliance questions.
Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.
Facilities can limit their exposure to claim denials and external reviews by implementing a robust internal coding compliance program. This article breaks down components of a coding policy and compliance plan and approaches to monitoring coding quality.
Although many provisions of the 2022 Outpatient Prospective Payment System (OPPS) final rule are a light lift for hospitals, several have far-reaching implications. Apply these expert tips to ensure you're up to speed and aware of compliance pitfalls.
