Hospitals must provide uninsured or self-pay patients with good faith cost estimates for services, according to an interim final rule (IFR) released September 30 implementing provisions of the No Surprises Act.Read More »
CMS is rescinding audit determinations for off-campus provider-based departments that claimed the mid-build exception under the 21st Century Cures Act,Read More »
National hospital prescription drug expenditures are surging. In 2019, non-federal hospitals and clinics spent $36.9 billion and $90.3 billion, up 1.5 percent and 11.8 percent from 2018, respectively, according to a July 2020 article in the American Journal of Health System Pharmacy.Read More »
CMS will begin reprocessing 2019 claims for some services rendered at excepted off-campus provider-based departments. The affected claims are for services represented by HCPCS code G0463 (hospital outpatient clinic visit for assessment and management of a patient) with dates of service between...Read More »
CMS is expanding payments for at-home COVID-19 vaccinations to include communal spaces in multi-unit living settings or communal arrangements.Read More »
Q: How should we bill for trauma activation without pre-hospital notification and how should we capture charges for these services? Do we bundle the charge in with the facility evaluation and management (E/M) code?Read More »
Finding and addressing the roor causes of coding edits is essential to revenue integrity, but when the issue points back to clinical departments it can often be a challenge to get them on board with change. Use these tips to gain clinical departments' support and implement practical,...Read More »