Year: 2018

A decade ago, CMS enacted Hospital Inpatient Prospective Payment System (IPPS), a policy that penalizes hospitals for hospital-associated conditions (HAC) not present during admission. Recent research published in Infection Control & Hospital Epidemiology has shown the program has had minimal impact on hospital reimbursement. The researchers also found associated billing codes were “rarely used” by […]

A major shift in the reporting of transgender issues is at hand. They’re here, but it won’t be until sometime until after 2022 that the United States is expected to adopt the codes of ICD-11 – the new International Classification of Diseases, Version 11 – released by the World Health Organization (WHO) in Geneva. According […]

Patients’ financial responsibility for their healthcare is on the rise and showing no signs of slowing down. Long gone are the days of $25 co-pays and $250 deductibles. A TransUnion Healthcare analysis showed that patients experienced an 11 percent increase in average out-of-pocket costs during 2017, rising from $1,630 in the last quarter of 2016 […]

Here’s a summary of the changes for the July update to the 2018 Medicare Physician Fee Schedule Database (MPFSDB). Changes are effective for dates of service on and after July 1, 2018. Indicator Change for RHC and FQHC Care Management Codes. For the following two HCPCS Level II codes, the PC/TC indicator is changed to […]

Clinical diagnostic laboratories can look forward to 12 new laboratory codes were effective April 1 and one code effective retroactively January 1. The Centers for Medicare and Medicate Services (CMS) released the changes May 5, 2018. The new codes are contractor priced until addressed at the annual Clinical Laboratory Public Meeting in July. All the […]

After patients have a subcortical stroke in the right hemisphere of their brain, more than one in three experience cognitive decline. That decline may be the result of damage to specific pathways in the brain, according to a new study published in Radiology. “Impairment of attention has been observed in patients with both cortical and […]

Medpac Suggests Cutting Medicare Reimbursement For Stand-alone Emergency Departments The Medicare Payment Advisory Commission (MedPAC) recently voted to reduce Medicare reimbursement by 30 percent for off-campus stand-alone emergency departments (ED) in urban areas. The recommendation will be included in the commission’s June 2018 report to Congress. MedPAC expressed concerns that stand-alone EDs in urban areas resulted in […]

The ICD-10-CM Tabular List of Diseases and Injuries 2018 Addenda provides insight to future diagnosis coding. Let’s review what is new, deleted, and revised in chapters 1-7. In future months, we will cover additional chapters. Chapter 1: Certain Infectious and Parasitic Diseases (A00-A09) Two codes are added under A04.7: A04.71 Enterocolitis due to Clostridium difficile, […]