Billing and Claims

HHS released a policy roadmap for providers ahead of the public health emergency (PHE) conclusion. The roadmap details policies that will simultaneously end with the PHE, as well as flexibilities that have been extended for various time periods.

CMS recently published an FAQ to address the products, providers, and billing practices associated with drug waste modifiers -JW and -JZ.

As we start 2023, one of the biggest questions is the fate of the COVID-19 public health emergency declaration (PHE).

Look ahead to a bright future in revenue integrity.

Ronald Hirsch, MD, FACP, CHCQM, CHRI, shares tips for preparing for the end of emergency waivers.

Learn how CMS’ changes will affect hospital reimbursement.

Ensure you’re complying with new rules for billing and coding.

Brush up on hospital compliance requirements with surprise billing rules.

Q: If an anesthesiologist performs a presurgical or postsurgical block for pain control and it is performed in a holding area rather than in the operating room (OR), can we bill a separate facility (technical) fee for that? Or would this be bundled with OR services?

The Office of Inspector General (OIG) recently released its annual report on solutions to reduce fraud, waste, and abuse in HHS programs. In the OIG’s 2022 report, 16 of the top 25 unimplemented recommendations involve CMS, with three relating to Medicare Parts A and B.