Telehealth coverage may be changing in your state as early as this fall—if it hasn’t already. While Medicare has pledged to cover telehealth services through December 2023, many state public health emergency waivers that expanded telehealth services are set to be rolled back.
The 3-day payment rule is known to coders by various names such as the 72-hour rule, the 3-day payment window, or MS-DRG window policy. Kimberly Lee M.Ed., RHIA, CCS-P, describes how to navigate the rule’s nuances for billing purposes.
To better prepare for the rest of the year, here are some topical privacy and security compliance tips and reminders as we surge toward a strong second half of 2022.
Case managers are overburdened and understaffed in hospitals across the country. With a tight job market, it’s likely that the crunch won’t lessen any time soon, so many organizations are looking to increase efficiency to ensure that they continue to meet the needs of their patients.
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.
