To support the sudden increase in test results and medical records being transmitted during the pandemic, hospitals, laboratories, and pharmacies implemented additional devices and remote connections into their networks. After the Office for...
More InfoA CMS-run care delivery model focused on addressing social determinants of health has effectively identified higher cost and utilization patients while reducing potentially unnecessary emergency department (ED) visits, a new report shows. The...
More InfoWe have received a number of questions from those seeking advice on choosing a coding level when using the new 2021 evaluation and management (E/M) guidelines. The most common questions concern the meaning and interpretation of ideas within the 3...
More InfoTypical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors upon hospitals, with added costs to treat patients...
More InfoThe clinical documentation improvement (CDI) vendor landscape has undergone significant changes over the last couple of years, including vendor acquisitions and technology developments. And these changes and other factors have had an impact on...
More InfoTo select a level of an E/M service, two of the three elements of MDM must be met or exceeded. Q: How do you select an E/M code for an outpatient visit based on documentation of medical decision-making (MDM)? A: Per the 2021 E/M guidelines...
More InfoTelehealth, remote monitoring will boost patient outcomes and value-based care results Limited by the slow pace of change in traditional reimbursement models, shifts in the paradigm for patient care have also lagged far behind the possibilities...
More InfoMany healthcare organizations quickly adopted telehealth programs out of necessity at the start of the COVID-19 pandemic, expanding their attack surface with the integration of new technology such as mobile telehealth apps and wearable heart rate...
More InfoThe final rule also clarifies the definition of “reasonable and necessary.” On Jan. 14, the Centers for Medicare & Medicaid Services (CMS) published a final rule creating a new Medicare coverage and reimbursement pathway for “breakthrough”...
More InfoMedicaid physician reimbursement rates in the fee-for-service part of the program were about 72% of Medicare rates for the same service, a new study finds. Medicaid physician reimbursement is significantly lower than commercial payer and even...
More InfoWith all that has happened over the past year, from the coronavirus pandemic to ongoing social justice movements, healthcare workers and organizations are standing in solidarity with their communities like never before. While these corresponding...
More InfoThe NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule. CMS on January 27 updated coding and billing instructions to hospitals for new COVID-19 treatments add-on payment (NCTAP). The NCTAP was finalized as part of CMS’ fourth...
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