The American Hospital Association, Community Oncology Alliance, and other hospital organizations expressed concerns regarding CMS’ proposed mandatory payment model for radiation oncology (RO), which if finalized, would go into effect January 1.
Perhaps the most momentous Quality Payment Program (QPP) news in the 2020 Medicare Physician Fee Schedule proposed rule is the Pathways version of the Merit-based Incentive Payment System (MIPS)—but that’s not happening until 2021.
A wide range of diagnostic tests may be used by hospital providers to examine respiratory functioning. In this article, Shelley C. Safian, PhD, RHIA, HCISPP, CCS-P, CPC-I , interprets CPT guidance for reporting pulmonary functioning tests used to diagnose patients with asthma and chronic obstructive pulmonary disease.
With much of the coding workforce working remotely, the inpatient coding manager must implement some control mechanisms to ensure the distractions at home are not interfering with the quality and quantity of work expected from the staff. In this article Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS, gives suggestions on the various ways to monitor your remote coding staff, including tips for conducting coding reviews. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Joe Rivet, JD, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, reviews how to report the stage and type of various skin ulcers, the fiscal year (FY) 2020 guideline updates for pressure ulcers, and common terminology traps inpatient coders can get tripped up by.
Q: Our coding team saw that there is a new section for radiation therapy in the FY 2020 ICD-10-PCS Official Guidelines for Coding and Reporting . Can you explain the recent changes made to this section?
In part one of this two-part series, Sharme Brodie, RN, CCDS , reviews the recent guidance from Coding Clinic , Second Quarter 2019, including cardiac conditions, transplants, and more.
As Medicare Advantage makes strides to becoming the new norm, organizations need to establish new processes, educate staff, and advocate for patients. Learn how your organization can keep pace with change before it’s too late to catch up.
Device-dependent edits require reporting a device code with procedures CMS has designated to be device intensive, and they are meant to ensure that device costs are accounted for in Medicare rates for device-intensive procedures.
Managers should not assume that they can review every guideline, every item in Coding Clinic, or every coding-related issue targeted by the OIG or Recovery Auditors. However, those issues that have been identified as the result of denials, external coding audits, or quality initiatives should surface to the top of the audit list for the coding manager.
Endometriosis is a condition where the tissue that usually grows in the lining of the uterus grows outside of the uterus. This typically happens in the neighboring sites of the uterus such as the ovaries, the fallopian tubes, the pelvic peritoneum, or even the intestines.
I can teach CDI to anyone. Just get the providers in a room with me; they don’t even have to be willing participants. While I have heard many times that physicians only listen to other physicians, I believe my success has less to do with the initials at the end of my name and more with the fact that the CDI cause is just, and I’m passionate when I teach.
In August, CMS released the fiscal year (FY) 2020 IPPS final rule , which affects approximately 3,300 acute care hospitals and applies to discharges occurring on and after October 1, 2019. With the massive amount of information covered in the final rule, this overview will pinpoint some of the most important aspects for inpatient coders and hospitals to review.
Q: The 2020 ICD-10-CM update added several new codes for legal interventions. What are these codes, and can they be assigned based on nonphysician documentation?
U.S. District Judge Rosemary M. Collyer recently ruled that CMS exceeded its authority when it expanded a site-neutral payment policy that cut reimbursement for certain E/M services provided in previously excepted off-campus hospital clinics.