While the calendar year 2020 OPPS proposed rule is shorter than in prior years (819 pages for the display version), the proposed policies therein pack a punch and may be thought of as a new day dawning for the future of hospital services.
In response to a formal request for information from industry stakeholders, CMS received 567 comments on ways to improve its Patients Over Paperwork Initiative, including many requests from hospital groups to simplify billing and prior approval requirements.
CMS proposed a new framework for the Merit-based Incentive Payment System (MIPS) intended to make the transition to value-based care easier for physicians. Read up on the proposed framework, MIPS Value Pathways (MVP), and its potential impact on patients and providers beginning in 2021.
When applying CPT modifiers -80, -81, and -82, physician coders must carefully consider details in the operative note. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , writes about the correct application of modifiers used to identify services performed by surgical assistants.
Evolving diagnostic terminology and a general lack of awareness surrounding gender fluidity can cause confusion for healthcare providers and coders. Review key considerations for the ICD-10-CM reporting of biological sex, gender identity, and other gender-related diagnoses. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Regularly reviewing hospital-acquired conditions (HAC) and preparing for unanticipated reporting situations will ensure your facility can submit these with the utmost accuracy. Joe Rivet, JD, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, helps coders better understand HACs by outlining the basics and giving tips for improving inpatient documentation and coding for these conditions.
CMS released the FY 2020 IPPS final rule on August 2, which finalized its decision on requests for new MS-DRG designations for chimeric antigen receptor T-cell (CAR-T) therapies. Upheld from the proposed rule, CMS denied these requests.
Q: What would be reported as the principal diagnosis if a patient was admitted with both a urinary tract infection (UTI) and sepsis? What would be reported first if the patient developed a catheter-associated UTI with sepsis?
