Revenue Integrity Insider

CMS issues payment fixes, updates to reimbursement and more in 2025 OPPS final rule

Wednesday, November 6, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS gave the green light to improved payments for high-cost radiopharmaceuticals and made changes to its payment calculation for cardiac CT services among other updates in the 2025 Outpatient Prospective Payment System (OPPS) final rule.Read More »

Revenue Integrity Insider

New codes and updates for outpatient skin substitute claims

Wednesday, October 23, 2024
Billing and Claims, Coding and Documentation, Revenue Integrity

CMS added new Healthcare Common Procedure Coding System (HCPCS) codes and made status indicator (SI) and code descriptor changes for outpatient skin substitute claims.Read More »

Revenue Integrity Insider

CMS issues PrEP NCD

Wednesday, October 9, 2024
Billing and Claims, Coding and Documentation, Coverage, News

CMS recently issued a final national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) using antiretroviral drugs to prevent HIV in high-risk individuals.Read More »

NAHRI Journal - Volume 8, Issue 4

New CAR-T codes

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

Review proposed changes to coding and reimbursement for chimeric antigen receptor T-cell (CAR-T) services.Read More »

NAHRI Journal - Volume 8, Issue 4

Putting the 2025 OPPS proposed rule under the microscope

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at major changes in the works for outpatient reimbursement.Read More »

NAHRI Journal - Volume 8, Issue 4

Navigating the 2025 MPFS proposed rule

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes could impact your organization.Read More »

NAHRI Journal - Volume 8, Issue 4

Different payment policy rationale in different CMS rules raises serious questions

Wednesday, October 2, 2024
Billing and Claims, Coding and Documentation, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Jugna Shah, MPH, CHRI, highlights the need for Medicare payment policy changes.Read More »

NAHRI Journal - Volume 8, Issue 4

Download the October 2024 issue of the NAHRI Journal

Wednesday, October 2, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Set the stage for success and close out the year strong.Read More »

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