Evaluation and management (E/M) coding and reimbursement for hospital outpatients could change dramatically if CMS finalizes its proposal to replace current E/M CPT ® codes with three G codes. Dave Fee, MBA, Peggy S. Blue, MPH, CCS-P, CPC, Jugna Shah, MPH, Kimberly Anderwood Hoy, JD, CPC, Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, and Valerie A. Rinkle discuss the possible impact if CMS finalizes its proposal.
CMS added three new HCPCS C codes and one G code to the integrated outpatient code editor (I/OCE) as part of the October quarterly update. The new codes are effective October 1.
CMS added additional ICD-10 MLN educational resources to its website and will be hosting an ICD-10 National Provider Call August 22. The new MLN educational resources include two fact sheets and a...
First we saw the new ICD-10-PCS codes and guidelines in May, followed by the new ICD-10-CM codes in June and the ICD-10-CM guidelines in July. Now we have updated general equivalence mappings (GEMs)...
CMS has been gathering information about the use of observation services and short inpatient hospital stays because hospitals have been placing patients in observation for longer periods of time. CMS recently finalized a change that will substantially affect how hospitals bill for observation stays, long outpatient stays, and short inpatient stays.
Eight CPT ® codes for multianalyte assays with algorithmic analyses (MAAA) procedures are now classified as not covered under OPPS (status indicator E), retroactive to January 1, 2013. These codes are now subject to I/OCE edit 9.
The recent ACDIS 2013 ICD-10 Preparation Survey found that 48 % of respondents don’t plan to add coding staff members to meet the challenge of ICD-10 implementation. Meanwhile, 66 % of respondents said they don’t plan to hire additional clinical documentation improvement (CDI) staff.
CMS and the Office of the National Coordinator for Health Information Technology recently hosted a listening session to gather industry feedback and concerns about health information technology adoption. Read some of the highlights of the session and comments from providers in the field.
CMS’ July update to the Integrated Outpatient Code Editor features new codes, new APCs, and a new modifier. Dave Fee, MBA, explains the most noteworthy changes for this quarter.
The U.S Centers for Disease Control and Prevention recently posted the updated ICD-10-CM guidelines . Narrative changes in the guidelines appear in bold text and content that moved within the guidelines is underscored.
October 1, 2014, is a little more than 14 months away. Where do your ICD-10 implementation plans stand? Do you know what resources you’ll need for the transition or when you should providing training...
The demand for coding labor may increase as much as 20%–40% over the next two years, according to a recent report, The State of H.I.M.: A Study of the Impact of ICD-10, CDI, and CAC Initiatives Within the Health Information Management Community. Trust Healthcare Consulting Services, LLC, which published the report, surveyed more than 300 HIM professionals in all types of healthcare facilities in nearly every state. The majority of participants (84%) were HIM directors.
Coders who want to get a head start on coding in ICD-10-CM can now download the 2014 ICD-10-CM codes from the Centers for Disease Control and Prevention (CDC) and CMS websites. The updated coding guidelines for ICD-10-CM are not available yet.
Do EHRs enable fraud and abuse by encouraging upcoding? What other factors could have led to higher levels of E/M coding over the past decade? Who or what organizations are responsible for ensuring compliance?
CMS is reexamining inpatient criteria because it has seen a significant increase in the number of patients spending more than 24 hours in observation. Providers are worried that a Recovery Auditor will deny a short inpatient stay for lack of medical necessity and recoup payment years later. So instead, some facilities place patients in observation for longer time periods.
CMS is reexamining inpatient criteria because it has seen a significant increase in the number of patients spending more than 24 hours in observation. James S. Kennedy, MD, CCS, CDIP, and Kimberly Anderwood Hoy, JD, CPC, discuss CMS’ proposed changes and how they could affect outpatient observation services.
ICD-10 implementation is less than 16 months away, but a recent survey by TrustHCS and AHIMA reveals that 25% of responding healthcare organizations have not yet established an ICD-10 steering committee.
Hospitals continue to report dramatic increases in Recovery Auditor (RA) activity, according to the latest RAC Trac survey results released June 4. The survey found that the number of medical record requests for survey respondents has increased by 53% in comparison to the cumulative total reported in the third quarter of 2012.
