When Spencer Johnson wrote the iconic book, Who Moved My Cheese? An A-Mazing Way to Deal With Change in Your Work and in Your Life, he probably didn’t have the homecare industry in mind. But with the speed of reimbursement and regulatory issues surrounding us today, he certainly could have.
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 Joint Commission continues to provide excellent resources to help healthcare organizations stay ready for surveys, as well as resources that help them meet and understand the intent of standards and elements of performance.
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.
HHS and the Office of Inspector General (OIG) recently released a resource guide outlining how to measure compliance program effectiveness. After surveying compliance professionals and staff from within HSS, seven key elements of compliance programs were identified.
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.
Accurate clinical documentation is the bedrock of the legal medical record, billing, and coding. It is also the most complex and vulnerable part of the revenue cycle.
When it comes to dealing with Medicare Recovery Auditors (RACs), there is never a dull moment for HIM professionals. Any shift in the RAC program quickly emerges as front-page news for HIM leaders.
Reimbursement for provider-based departments (PBD) can be complex, and regulations affecting it have changed frequently over the past year. Section 603 of the Bipartisan Budget Act of 2015, the 2017 outpatient prospective payment system (OPPS) final rule, and the 21st Century Cures Act changed the payment methodology and made multiple adjustments to the definition of excepted (on-campus or grandfathered off-campus) and non-excepted (off-campus) PBDs. Hospitals must know the regulations inside and out and understand how they apply to their PBDs and to avoid denials or noncompliance.
