The following is a tool for determining whether an individual supply item is considered to be “routine” for the purposes of creating a charge on the chargemaster.
After the FDA recently reclassified osteogenesis stimulators as class II devices, claims with certain HCPCS codes should no longer include modifier -KF.
Gain expert insights into the nuances of how CMS' rules affect reimbursement and what revenue integrity can do to protect compliant revenue and adapt to changes.
In the latest update to its Vaccine Administration National Fee Schedule, CMS established three Level II Healthcare Common Procedure Coding System (HCPCS) codes for billing a biosimilar used to treat COVID-19.
The Office of Inspector General (OIG) recently conducted an audit to identify potential vulnerabilities in the Medicare program that could be contributing to improper payments for virtual check-in and e-visit services.
CMS is weighing an expansion of the Comprehensive Care for Joint Replacement (CJR) model as well as cuts to disproportionate share hospital (DSH) payments, according to the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule.
