Healthcare organizations and providers are experiencing a shift in outpatient reimbursement: from fee-for-service to Alternative Payment Models and value-based reimbursement based on quality outcomes. Coding errors, documentation gaps, claim denials, and accounts not billed due to claim edits...Read More »
The April 2019 OPPS quarterly update reassigned specific skin substitute products from the low-cost group to the high-cost group, and clarified billing and reporting for chimeric antigen receptor T-cell (CAR-T) therapy procedures performed in the outpatient setting.Read More »
The Department of Health and Human Services (HHS) released a detailed overview on March 11 of its fiscal year 2020 budget, as HHS Secretary Alex Azar prepared for a gauntlet of hearings on Capitol Hill about the proposal.Read More »
Q: We are considering using of ICD-10 code Z79.899 (Other long term (current) drug therapy) to support medical necessity for lab testing while a patient is having chemotherapy. What is considered long term where this code is concerned?Read More »
The AMA’s CPT Editorial Panel approved sweeping changes to documentation and code selection guidelines for evaluation and management codes. If finalized, the changes will shift the way practices select codes for both office and facility visits as soon as January 2021.Read More »
Community Hospital in Munster, Indiana, is disputing an Office of Inspector General (OIG) report that found DRG assignment errors and incorrect inpatient rehabilitation facility (IRF) claims, resulting in an projected $22,051,602 in overpayments.Read More »