In the 2019 OPPS final rule, released November 2, CMS implemented several site-neutral payment policies, though the agency did delay or shelve other proposals due to stakeholder feedback.
As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption.
Developing an outpatient CDI program isn't just about metrics--departments needs to consider how to engage providers and interact with other teams to be truly effective.
It's been more than three years since CMS introduced a subset of modifiers it wants providers to report instead of modifier -59 (distinct procedural service), but they're still optional as barely any new guidance has been released.
CMS recently released updated guidance on billing intensity-modulated radiation therapy (IMRT) after an OIG audit found a 100% error rate in billing certain IMRT planning services.
It's been more than three years since CMS introduced a subset of modifiers it wants providers to report instead of modifier -59 (distinct procedural service), but they're still optional as barely any new guidance has been released.
Beginning in 2018, total knee arthroplasty (TKA) was removed from the Inpatient Only List and assigned a comprehensive APC payment. Outpatient coders need to ensure they are assigning the correct CPT codes for TKA to reduce their hospital’s risk of audits.
Outpatient procedures involving anesthesia should be reported using five-digit CPT codes as well as applicable hospital modifiers. Review types of anesthesia administration and documentation elements required for accurate code assignment. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The CMS risk adjustment model uses Hierarchical Condition Categories (HCC) to calculate risk scores based on ICD-10 diagnoses. Review HCC coding do’s and don’ts to help your facility manage risk effectively, enhance shared savings, and provide patient-centered care.
