In the 2020 Medicare Physician Fee Schedule final rule, CMS proposes to adopt four new time-based HCPCS codes to be used in place of existing CPT codes for complex and non-complex chronic care management (CCM) services.
High-risk general surgery patients have greater survival rates at major teaching hospitals than at non-teaching hospitals, according to a study published by the Annals of Surgery.
In the 2020 Medicare Physician Fee Schedule final rule, CMS increased the performance threshold for Merit-based Incentive Payment System (MIPS) eligible providers and finalized its proposal to implement the MIPS Value Pathways (MVP) framework in calendar year 2021.
CMS released the calendar year (CY) 2020 Medicare Physician Fee Schedule and OPPS final rules approving changes to E/M documentation guidelines, introducing new HCPCS codes, and continuing its potentially unlawful payment policy for drugs purchased through the 340B drug discount program.
The Centers for Disease Control and Prevention (CDC) recently released documentation guidance for providers who evaluate patients with symptoms of e-cigarette- or vaping-associated lung injury, as well as official ICD-10-CM coding guidance for reporting these encounters.
During the September ICD-10-CM Coordination and Maintenance Committee meeting, the Centers for Disease Control and Prevention (CDC) released a proposal to add, delete, and revise various ICD-10-CM codes for reporting sepsis.
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.
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.
CMS is finalizing its proposal to create two new MS-DRGs for endovascular cardiac valve procedures with and without MCC, according to the fiscal year 2020 IPPS final rule.
The American Medical Association released the 2020 CPT code set on August 26, introducing 248 new codes including many for drug implants, dry needling, and cardiac drainage procedures.
In August, U.S. District Judge David Ezra in Texas dismissed a case against Baylor Scott & White Health that alleged the organization falsely billed for millions in false claims for Medicare reimbursement.
In response to a formal request for information from industry stakeholders, CMS received 567 comments on ways to improve its Patients Over Paperwork Initiative, including many requests from hospital groups to simplify billing and prior approval requirements.
CMS released the FY 2020 IPPS final rule on August 2, which finalized its decision on requests for new MS-DRG designations for chimeric antigen receptor T-cell (CAR-T) therapies. Upheld from the proposed rule, CMS denied these requests.
The four organizations that make up the Cooperating Parties for ICD-10 recently approved the 2020 ICD-10-CM guidelines, which include updated guidance for reporting pressure-induced deep tissue damage, multiple drugs or medicinal substances, injuries and complications.
CMS released the fiscal year (FY) 2020 IPPS final rule on August 2 with updates to payment rates and wage index values, changes to CC/MCC designations, and revisions to various MS-DRGs. Policy updates affect approximately 3,300 acute care hospitals and apply to discharges beginning October 1.
CMS released the calendar year (CY) 2020 Medicare Physician Fee Schedule (MPFS) and OPPS proposed rules on July 29, introducing new CPT codes and extensive changes to documentation requirements for E/M office visits, and seeking commentary on how to overhaul MIPS and potentially undo its payment policy for drugs purchased through the 340B discount program.
A retrospective billing study conducted by researchers at Mayo Clinic in Jacksonville, Florida, showed that pre-existing psychiatric comorbidities independently predicted elevated healthcare costs for a large population of patients treated with radiation at the institution.
A Medicare billing study recently published in The Journal of Hand Surgery found that provider reimbursement for magnetic resonance imaging (MRI) and computed tomography (CT) scans of the upper extremities significantly decreased over the last decade.
