Pain management during the global period of a procedure, if related to that procedure, is not separately reportable. If a provider other than the operating provider performs follow-up care, you must be careful to avoid “unbundling” of that follow-up care. The global period, or global surgical package, bundles all care typically related to surgical service into a […]
CMS has released the inpatient psychiatric facility proposed rule. Approximately $75million is projected to be paid to inpatient psychiatric facilities (IPF), according to the Centers for Medicare & Medicaid Services (CMS) proposed 2020 inpatient prospective payment system (IPPS) released on April 19. IPF-PPS applies to inpatient services for psychiatric hospitals and distinct psychiatric units of […]
This year’s reporting for the Quality Payment Program will affect the 2021 payment year. Kevin J. Corcoran, COE, CPC, CPMA, FNAO, delivered his annual update at Hawaiian Eye 2019, highlighting changes CMS would be making this year for coding, payment issues, regulatory matters, administrative issues and reimbursement issues. The Medicare Physician Fee Schedule did not […]
Moderate sedation coding, also sometimes referred to as conscious sedation, is a drug-induced depression of consciousness. A patient who has been sedated in this way is relaxed and generally insensitive to pain, but remains awake and able to respond to verbal instruction. If medically necessary and properly documented, moderate sedation is a separately reported service. […]
The focus on electronic health record implementation has turned to how to make use of the vast data stored within to improve revenue cycle operations. “These EHRs capture so much data. The trick is translating that data into information,” said Cynthia Sikina, vice president of Financial Services with consulting firm Afia. The EHR is not providing […]
Suggestions for conducting peer-to-peer appeals for denials management. Claims Automation has been a part of the workers’ compensation and auto casualty industries for years, but today, a large opportunity still remains to increase in the claims automation process. The future of automation in the Property and Casualty industry is not to replace jobs but instead […]
The Centers for Medicare & Medicaid Services’ Patient-Driven Payment Model (PDPM) takes effect on Oct. 1. When the reform takes effect, long-term post-acute care (LTPAC) facilities will see a big change in how they receive payment for delivering valuable patient care. While the payment reform will inevitably bring challenges, it will also present a significant […]
Chronic Kidney Disease (CKD) is a serious health condition affecting millions of people worldwide. In the United States alone, 15% of adults, or approximately 37 million people, suffer from CKD. This condition, often insidious in its onset, can lead to severe complications and significantly impact quality of life. Key Facts about CKD: Prevalence: More common […]
GET OUT YOUR 2019 CPT® CODE BOOKS. YOU HAVE SOME CODE CHANGES TO MAKE. Effective July 1, 2019, the American Medical Association (AMA) is adding 21 new lab codes and deleting one in Appendix O, Multianalyte Assays with Algorithmic Analyses and Proprietary Laboratory Analyses. Deleted 0057U Oncology (solid organ neoplasia), mRNA, gene expression profiling by […]
The new codes include drugs for migraines, to initiate blood-clotting in patients on certain coagulants, chronic and hairy cell leukemia, and folic acid for chemotherapy patients. The home health codes help facilitate the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) Pioneer ACO initiative. New HCPCS Level II Codes […]