Pain management during the global period of a procedure, if related to that procedure, is not separately reportable. If a provider other than the operating provider performs follow-up care, you must be careful to avoid “unbundling” of that follow-up care. The global period, or global surgical package, bundles all care typically related to surgical service into a […]
CMS has released the inpatient psychiatric facility proposed rule. Approximately $75million is projected to be paid to inpatient psychiatric facilities (IPF), according to the Centers for Medicare & Medicaid Services (CMS) proposed 2020 inpatient prospective payment system (IPPS) released on April 19. IPF-PPS applies to inpatient services for psychiatric hospitals and distinct psychiatric units of […]
This year’s reporting for the Quality Payment Program will affect the 2021 payment year. Kevin J. Corcoran, COE, CPC, CPMA, FNAO, delivered his annual update at Hawaiian Eye 2019, highlighting changes CMS would be making this year for coding, payment issues, regulatory matters, administrative issues and reimbursement issues. The Medicare Physician Fee Schedule did not […]
The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations (IRF). Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers for Medicare & Medicaid […]
Suggestions for conducting peer-to-peer appeals for denials. If you are wondering why you should read this if you think you are not a rebeginner, well, it is because you actually are one. Beginnings do not disappear, they just reproduce. Novices are just starting, veterans have started over and over. We all begin as beginners and […]
Complications of chronic kidney disease (CKD) include early death and heart disease. Chronic kidney disease (CKD) affects 15 percent of United States adults, or 37 million people, according to a recent statement by the Centers for Disease Control and Prevention (CDC). The following are some basic facts about CKD; specifically, it is: More common […]
A new collaboration between the AMA and UnitedHealthcare will work to address the social and environmental factors that affect patients’ health by standardizing data collection on their social determinants of health (SDOH) to help address individuals’ unique needs that often go unmet. The two organizations are supporting the creation of 23 new ICD-10 codes related […]
The new codes include drugs for migraines, to initiate blood-clotting in patients on certain coagulants, chronic and hairy cell leukemia, and folic acid for chemotherapy patients. The home health codes help facilitate the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) Pioneer ACO initiative. New HCPCS Level II Codes […]
Value based payment models are undoubtedly the future of health care. The number of commercial and governmental ACO contracts alone increased by an average of 63% annually from Q1 2011 to Q1 2018, according to a Muhlestein et al. analysis of Leavitt Partners’ data. Though commercial payers have been slower to adopt other models that […]
President Trump’s fiscal year (FY) 2020 budget allows for $87.1 billion in discretionary budget authority and $1.2 trillion in mandatory funding for the U.S. Department of Health and Human Services (HHS). Although the Centers for Medicare & Medicaid Services (CMS) commands the lion’s share of HHS’s budget, the Trump administration has found ways to cut $395 million […]