CMS made certain concessions from its proposed site-neutral payment policies required by Section 603 of the Bipartisan Budget Act, but it is still moving forward with implementation January 1, 2017, according to the 2017 OPPS final rule.
Each year, CMS reviews procedures on the inpatient-only list, which consists of services typically provided on inpatients and not payable under the OPPS, to consider whether they are being performed safely and consistently in outpatient departments.
As it does each year, CMS reviewed its packaging policies and proposed numerous modifications for 2017, finalizing a move to conditionally package at the claim level and deleting the controversial modifier used to identify separately reportable laboratory tests.
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS, writes about methods coders can use to improve the quality and detail of physician documentation to ensure important information is captured.
The complex anatomy of the arm, wrist, and hand can make coding for procedures on them challenging. Review the bones of the arm and common codes used to report fractures and dislocations.
Q: We are a critical access hospital and don’t get paid under the OPPS. We get reimbursed based on our cost of procedures, tests and services. Is modifier –JW (drug amount discarded/not administered to any patient) applicable to us beginning in January?
With the grace period from CMS for reporting unspecified ICD-10-CM codes over, Erica E. Remer, MD, FACEP, CCDS, writes about diagnoses to target for improvement.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP , reviews changes that were made in the 2017 ICD-10-PCS Official Guidelines for Coding and Reporting to arteries and stents. Note: To access this free article, make sure you first register for the free content if you do not have a paid subscription.
Q: When coding and trying to sequence a diagnosis such as pneumonia and chronic obstructive pulmonary disease, I understand that there is a “use after” mandate, but how are coders to know which codes the “use additional code” note is providing sequencing advice for?
Laura Legg, RHIT, CCS, CDIP, AHIMA-approved ICD-10-CM/PCS trainer, writes that coders need to review the newly released coding guidelines in detail in order to understand the changes and implications the new standard for clinical validation has on their facilities.
On October 31, CMS announced that it awarded contracts to the next round of Medicare fee-for-service Recovery Auditors. The base period for contracts is 12 months from the date the contract is awarded, said CMS.
MS-DRG audits are nothing new, but their frequency has significantly increased over the last two years. In this article, Sam Antonios, MD, FACP, FHM, CPE, CCDS , gives facilities tips to increase the likelihood of overturning MS-DRG denials.
Providers frequently need to treat fractures in the ED, so coders need to be aware of the types of fractures and how to report them using CPT codes. Review types of fractures, treatment, and coding tips for reporting fractures in the ED.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, continues her look at 2017 diagnosis code changes for genitourinary conditions by focusing tips for reporting urinary and male genitourinary diagnoses.
CMS released the 2017 OPPS final rule November 1, implementing site-neutral payment policies required by Section 603 of the Bipartisan Budget Act, adding new comprehensive APCs, and refining several packaging policies.
Providers need to make sure that electronic order templates include all the necessary information to bill correctly and avoid issues during audits. Valerie A. Rinkle, MPA, writes about what must be contained in the order and ICD-10-specific updates providers should consider.
