CMS released Transmittal 3950 on January 12 describing updates to a list of the HCPCS codes for Durable Medical Equipment Medicare Administrative Contractors and Part B Medicare Administrative Contractor jurisdictions.
Only 12% of eligible hospitals signed up for CMS’ Bundled Payments for Care Improvement Model 2 initiative and 47% of them dropped out completely within two years, according to a recent study by the Journal of the American Medical Association .
Medicare fee-for-service claims had a 90.5% accuracy rate and a 9.5% improper payment rate for all claims submitted between July 1, 2015- June 30, 2016, according to a recent CMS Comprehensive Error Rate Testing report.
On January 9, CMS announced the launch of Bundled Payments for Care Improvement Advanced from the agency’s Center for Medicare and Medicaid Innovation.
With providers continuing to expand clinical documentation improvement efforts into outpatient settings, ACDIS has published a position paper offering guidance to outpatient CDI departments for performing queries.
A report released by the American Hospital Association and Manatt Health found that facilities spend approximately $39 million annually to comply with 629 requirements across nine regulatory domains.
Upon reviewing 2,145 inpatient claims at 25 providers, the Office of Inspector General (OIG) found that all but one claim incorrectly included the ICD-9-CM diagnosis code for kwashiorkor (260). This resulted in overpayments in excess of $6 million, according to the OIG report .
Recent findings support the possibility that the Hospital Readmissions Reduction Program has had the unintended consequence of increased mortality in patients hospitalized with heart failure, says a study published by JAMA .
Providers will no longer be required to append modifier -GT (via interactive audio and video) to professional telehealth claims, effective January 1, 2018, according to a policy CMS finalized in the 2018 Medicare Physician Fee Schedule (MPFS) final rule.
While the 2018 OPPS final rule may be controversial for its payment cuts to drugs purchased through the 340B drug discount program, it contains several provisions supported by hospitals and other stakeholders.
Within the span of two days last week, CMS released final rules for three comprehensive policies, which have important financial implications for hospitals, physicians, and medical professionals in 2018.
Inpatient stays involving any opioid-related diagnosis increased by 14.1% after ICD-10-CM was implemented in 2015, according to a study recently published in Medical Care .
A Comprehensive Error Rate Testing (CERT) study showed insufficient documentation causes most improper payments for arthroscopic rotator cuff repairs, according to the October 2017 Medicare Quarterly Compliance Newsletter .
On October 4, CMS issued a notice in the Federal Register containing numerous corrections to the 2018 IPPS final rule, including significant recalculations of MS-DRG relative weights and all budget neutrality factors.
The October 2017 OPPS quarterly update introduced 12 new proprietary laboratory analysis CPT codes as well as a new modifier for a biosimilar biological product.
While the Affordable Care Act has led to fewer 30-day readmissions, this reduction in readmissions does not correlate with 30-day mortality rates, according to a recent JAMA study.
As part of the October 2017 OPPS update, CMS will revise its policy on upper eyelid blepharoplasty and blepharoptosis repairs to allow physicians to receive payment for medically necessary blepharoptosis repairs when performed with cosmetic blepharoplasty.
The Centers for Disease Control and Prevention (CDC), one of the Cooperating Parties responsible for the ICD-10-CM codes and guidelines, recently released a 2018 ICD-10-CM Official Guidelines for Coding and Reporting errata. Slight changes were made to the guidelines for diabetes, hypertension, and principal diagnosis selection.
The 2018 updates to the CPT Manual released in early September feature a total of 314 code changes. New codes for E/M visits, genetic testing services, and endovascular repairs of aortic aneurysms are among the 172 additions.
