Q: Are there any updates on the Evaluation and Management code requirements? A: The American Medical Association (AMA) has now weighed in with their E/M coding requirement modifications, which means that all payers will be affected in 2021. If you remember, Medicare announced plans to revamp the E/M coding structure in 2018 and was met with […]
Dive Brief CMS Administrator Seema Verma announced Thursday the agency will overhaul coding regulations that she argues have hindered beneficiary access to new medical technology. Medical device companies will now be able to apply for a new permanent Healthcare Common Procedure Coding System (HCPCS) code twice a year, instead of annually. CMS also recently eliminated […]
The FY 2020 Inpatient Prospective Payment System (IPPS) proposed changes could bode well for many facilities. There has been much discussion about the Centers for Medicare and Medicaid (CMS) Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2020 proposed rule and its suggested changes. Good news can be found in the 1,824 pages of […]
Medicare payments for the top 10 current procedural terminology codes performed by ASCs are expected to remain relatively stable in 2019 compared to 2018, according to VMG Health. 66984: Cataract surgery with insertion of intraocular lens prosthesis (one-stage procedure), manual or mechanical technique Estimated 2017 payments: $1,172 Estimated 2018 payments: $1,206 Estimated 2019 payments: $1,182 45380: […]
Don’t Count on The EHR For Billing Codes Electronic health records have a function, which practices can turn on or off, that suggests level of service codes based on documentation. But that’s only part of what goes into proper coding. It’s difficult for an EHR to determine the impact of things like risk, according to […]
The global medical billing outsourcing market is poised to expand for years to come as medical practices face challenges related to multiple payers and medical code representation, and large practices consolidate, according to a new report by Grand View Research. Five billing trends, based on the report: The global medical billing outsourcing market is projected to reach […]
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. […]