Coding audits are commonly used to determine the need for focused coder education and training. Learn about key considerations for conducting coding audits and summarizing significant audit findings.
Review up-to-date novel coronavirus (COVID-19) documentation tips, ICD-10-CM and CPT coding guidance, and advice for ensuring billing compliance during the public health emergency.
Physician practices have started reopening to patients but are not expecting a return to normal anytime soon. They continue to struggle with staffing shortages and lost revenue due to COVID-19 restrictions.
For FY 2021, CMS projects the rate increase, together with other proposed changes to IPPS payment policies, will increase IPPS operating payments by approximately 2.5%. Proposed changes in uncompensated care payments, new technology add-on payments, and capital payments will decrease IPPS payments by approximately 0.4%, according to the proposed rule. Therefore, CMS estimates a total increase in overall IPPS payments of approximately 1.6%.
Prior to 1983, Medicare reimbursed based on actual charges that inpatient healthcare facilities billed (often referred to as “fee-for-service” payments). The more tests, procedures, and services ordered by physicians, the more an organization was paid. This created the potential for unnecessary or excessive services, contributing to rising healthcare costs and the possibility of depleting Medicare funds.
PEPPER is an acronym for the Program for Evaluating Payment Patterns Electronic Report . The PEPPER was originated by the Hospital Payment Monitoring Program (HPMP) and Quality Improvement Organizations.
Determine the impact of new regulatory relief for hospitals regarding outpatient services and telehealth originating site services provided to patients at alternate locations, including their homes.
