Year: 2021

Hospital Payments Increase 2.8% Under CMS Proposed Rule

Hospital Payments Increase 2.8% Under CMS Proposed Rule

The Centers for Medicare and Medicaid Services has updated the Medicare fee-for-service payment rates and policies for inpatient hospitals and long-term care hospitals for 2022. Before taking into account Medicare disproportionate share hospital payments and Medicare uncompensated care payments, the proposed increase in operating payment rates, increases in capital payments, increases in payments for new […]
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CPT Coding For Excisional Wound Debridement With VAC

CPT Coding For Excisional Wound Debridement With VAC

Q: What CPT codes and modifiers would be used to report excisional debridement for removal of a 2×4-cm ulcer on a patient’s right buttocks with vacuum-assisted closure (VAC)? A: The debridement would be reported using CPT code 11042 (debridement, subcutaneous tissue [includes epidermis and dermis, if performed]; first 20 sq cm or less). This procedure […]
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Health Policy Experts Offer 3 Fixes for Medicare’s ‘Dysfunctional’ Advanced-Imaging Payment System

Health Policy Experts Offer 3 Fixes for Medicare’s ‘Dysfunctional’ Advanced-Imaging Payment System

  Medicare Radiology Payment System approach to advanced imaging reimbursement has been “dysfunctional” for decades, but health policy experts have a few suggestions to fix it. Over the past 20 years, the federal payment program witnessed “substantial” increases in the performance of MRIs, CT scans and nuclear studies, mostly in doc offices. A shift later […]
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AHA Coding Clinic on ICD-10-CM_PCS for First Quarter of 2021 Released

AHA Coding Clinic on ICD-10-CM/PCS for First Quarter of 2021 Released

Current issue includes most frequently asked questions about coding COVID-19. The American Hospital Association (AHA) central office is the official United States clearinghouse on medical coding for the proper use of the ICD-10-CM/PCS systems and Level I HCPCS (CPT-4 codes) for hospital providers – and certain Level II HCPCS codes for hospitals, physicians, and other health professionals. The […]
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Prior Authorization Burden Still High Despite COVID Struggles

Prior Authorization Burden Still High Despite COVID Struggles

Most physicians still faced a high prior authorization burden despite treating a surge of positive COVID-19 cases this winter, the American Medical Association (AMA) reports. In a survey of 1,000 practicing physicians between Nov. 23, 2020, and Dec. 14, 2020, AMA found that 85 percent of physicians described the burden associated with prior authorization as high […]
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Three Keys to Ease Provider Tension

Three Keys to Ease Provider Tension

Being a physician comes with certain baseline stressors. For most, the culprits are pretty familiar: patient care responsibilities, high debt loads that compel long working hours, system complexities, and mounting administrative chores. COVID-19 has added yet another layer to the burdens that already contribute to physician burnout. As an emergency physician, walking into work every […]
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CMS Proposes Medicare Payment Bump for Rehab, Psychiatric Facilities

CMS Proposes Medicare Payment Bump for Rehab, Psychiatric Facilities

  CMS has released the proposed rules for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the Inpatient Psychiatric Facility Prospective Payment System for fiscal year (FY) 2022. Issued yesterday, the proposed FY 2022 IRF Prospective Payment System rule would increase Medicare payments by 1.8 percent, or $160 million, compared to the previous fiscal year. The […]
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