A review of Medicare CT scan claims from July 2011 to June 2012 found that 16% claims had an improper payment rate, according to the most recent Medicare Quarterly Provider Compliance Newsletter .
Providers struggle to reconcile conflicts between recent CMS regulations and the CPT® Manual and other AMA publications. Jugna Shah, MPH , Valerie A. Rinkle, MPA , and Linda S. Dietz, RHIA, CCS, CCS-P , look at specific areas of confusion and how to code them accurately.
On Monday, the Senate passed a House of Representatives bill on Medicare payments that included a provision to delay ICD-10 implementation until at least October 1, 2015.
In the Medicare Quarterly Provider Compliance Newsletter , CMS writes about auditor findings for MRI scans that did not meet medical necessity and how to ensure documentation that supports it.
Changes implemented by the 2014 OPPS Final Rule resulted in the addition and deletion of many codes in the January I/OCE update. Dave Fee, MBA , reviews some of the most important modifications, including changes to evaluation and management services and device reporting.
CMS Administrator Marilyn Tavenner reiterated last week that ICD-10 implementation would not be delayed again, as CMS prepares for end-to-end testing of providers this summer.
An overwhelming 87% of respondents to a recent survey by Navicure of physician practices said they are at least "somewhat confident" they will be ready for ICD-10 implementation by October 1.
CMS will present the eHealth Summit: Road to ICD-10 from 9 a.m. to 3:30 p.m., Friday, February 14, in Baltimore and is inviting interested parties who cannot attend in person to register for a live webcast of the sessions .
Jugna Shah, MPH, and Valerie A. Rinkle, MPA, examine the 2014 OPPS Final Rule and explain which services are now packaged, including drugs and biological that function as supplies when used in diagnostic or surgical procedures, clinical diagnostic lab tests, and device removal procedures.
A recent survey of healthcare payers and providers by accounting firm KPMG shows that many organizations are lagging when it comes to ICD-10 testing. Nearly three-quarters of respondents said they had yet to begin end-to-end ICD-10 testing or were not planning on conducting it.
Coders have until September 30, 2015, to pass AAPC’s ICD-10 proficiency test in order to retain their credentials. AAPC recently added another way to prove proficiency that includes an online training portion, in addition to the previously available timed assessment.
CMS did not finalize a proposal to collapse all evaluation and management visits into three codes, but did change clinic visit level coding. Jugna Shah, MPH, and Valerie A. Rinkle, MPA, review some of the major changes to E/M levels for 2014 and the new codes introduced. introduced.
Documentation for vertebral augmentation procedures (VAPs) must adhere to Local Coverage Determination (LCD) policies in order to be paid by Medicare. CMS recently provided guidance for these claims in the Medicare Quarterly Provider Compliance Newsletter .
In its 2014 OPPS Final Rule , CMS finalized its proposal to replace existing evaluation and management CPT ® clinic visit codes with a single HCPCS G-code.
CMS recently released five online resources to aid providers in their ICD-10 implementation efforts. Although CMS designed some of these resources with providers in mind, much of the information is applicable to hospitals, payers, and vendors as well.
The 2014 IPPS Final Rule was supposed to be implemented with enforcement beginning October 1, but one of its most controversial aspects has seen another delay in enforcement, with major healthcare trade groups seeking more.
Small and mid-sized hospitals are increasing their ICD-10 training for staff, according to a recent Health Revenue Assurance Associates (HRAA) survey of 200 healthcare professionals. However, many still lag behind CMS’ timeline for dual coding and other implementation aspects.
Some of the most sweeping changes in OPPS history were proposed in the 2014 rule, including new packaging rules, quality measures, and changes to evaluation and management. Jugna Shah, MPH, and Dave Fee, MBA, look at some of the changes and how they could impact providers.
With less than a year until ICD-10 implementation, many facilities have yet to even begin training. A recent Association of Clinical Documentation Improvement Specialists survey shows how far along facilities are and their concerns as October 1, 2014, nears.
CMS’ proposed 2014 OPPS rule is set to introduce many changes, such as more packaged services, including lab tests and add-on codes. Jugna Shah, MPH; Dave Fee, MBA; Kimberly Anderwood Hoy, JD, CPC; and Valerie A. Rinkle, MPA, offer their insight on what effect these changes could have for providers.
