Recovery Auditors have identified improper payments for claims involving end-stage renal disease (ESRD) services when more than one monthly service was billed per month and per-day codes exceeded the limit, according to the latest Medicare Quarterly Provider Compliance Newsletter .
I’m almost afraid to read my email these days. It seems like every day brings a new group trying to delay ICD-10 or another piece of legislation that ICD-10 opponents might slip delay language into...
Beginning January 1, 2015, physicians will no longer need to provide certification for an inpatient admission unless the admission is expected to last for at least 20 days or the case is an outlier.
AHIMA is calling for coders, billers, and providers to contact Congress to ask for no additional delays to ICD-10 after physician groups have recently started to advocate for members to petition Congress to introduce a new, two-year implementation delay to push the compliance date to October 1, 2017.
The House of Representatives recently passed a bill that would impact supervision levels for certain outpatient services. Debbie Mackaman, RHIA, CPCO , reviews the impact of the legislation and which provider types and services it would affect.
CMS finalized a new data collection requirement for services performed in off-campus, provider-based clinics in the 2015 OPPS final rule , which was released October 31.
Beginning January 1, 2015, physicians will no longer need to provide certification for an inpatient admission unless the admission is expected to last for 20 days or longer or the case is an outlier.
Editor's note: Jugna Shah, MPH, president and founder of Nimitt Consulting, writes a bimonthly column for Briefings on APCs, commenting on the latest policies and regulations and analyzing their impact on providers.
Coders aren’t the only ones who run into problems due to a lack of complete physician documentation. Lack of sufficient documentation also causes problems for audit review of submitted claims, which in turn leads to delays in payment, according to the October 2014 Medicare Quarterly Provider Compliance Newsletter .
The four Cooperating Parties released the 2015 ICD-10-CM guidelines and, in the process, deleted a guideline that affects inpatient coding. Both the Centers for Disease Control and Prevention and CMS posted the new guidelines on their websites.
The October update to the OPPS and Integrated Outpatient Code Editor (I/OCE) includes a payment correction, in addition to new HCPCS codes and other changes. Dave Fee, MBA, reviews CMS' changes and details the retroactive payment correction.
In its latest survey of the healthcare industry's ICD-10 readiness, the Workgroup for Electronic Data Interchange (WEDI) found that this year's delay negatively impacted provider progress, with two-thirds reporting slowing down or putting implementation initiatives on hold as a result.
Recovery Auditors have uncovered incorrect secondary diagnoses in patients who underwent amputations for musculoskeletal and circulatory system disorders. CMS revealed the findings in its Quarterly Compliance Newsletter .
CMS recently updated the Medicare Claims Processing Manual , with changes announced in Transmittal 3020 , to include ICD-10-specific language ahead of next year's implementation.
ICD-10 implementation will impact different specialties and hospital departments in distinct ways. Andrew D. Boyd, MD, and Neeta K. Venepalli, MD, MBA , recently conducted a pair of studies to determine the financial and informational impact of ICD-10 on a variety of specialties.
CMS is introducing four new HCPCS modifiers to specifically define subsets of modifier -59 (distinct procedural service), the most frequently used modifier.
