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.
Automation and similar technologies are increasingly prevalent in revenue integrity but understanding best practices and long-term implications is still a major challenge. Learn how one organization is tackling misconceptions to make breakthroughs in deploying automation.
CMS finalized a higher-than-proposed payment increase that was almost erased for most non-drug services to offset ending reduced reimbursement for 340B drugs, according to the 2023 Outpatient Prospective Payment System (OPPS) final rule. Provisions of the rule, released November 1, also detail significant changes to payment for software as a service (SaaS) and behavioral and rural health programs, such as the rural emergency hospital (REH) designation, among other updates.
CMS is moving ahead with major changes to evaluation and management (E/M) services, telehealth, coverage of dental services, and more in the 2023 Medicare Physician Fee Schedule (MPFS) final rule. The rule, released November 1, also includes updates to vaccine payments and quality and reporting programs.
In the 2022 NAHRI Leadership Council Survey, Custom Edits—Creation and Workflow, 100 leaders, including revenue integrity, health information management (HIM), and coding directors and managers primarily from acute care hospitals and health systems with 500+ beds, described their custom edit...
Listening to NAHRI Quarterly Conference Call (free for NAHRI members) qualifies for one CHRI CEU credit upon the completion of the accompanying survey. If you’re a NAHRI member and are interested in presenting...
Q: We are a critical access hospital (CAH). We provide smoking cessation therapy (CPT codes 99406-99407) in our cardiac rehab department. The documentation is done and signed by a respiratory therapist (RT), and we are currently billing this as a professional charge (on a UB-04 with revenue code 0981). My question is, can we bill this on a UB-04 as a facility charge only and still allow our RT or other ancillary staff to perform it?
