Stick to the facts: Applying modifier -JW

Wed, 01/12/2022
NAHRI Journal - Volume 6, Issue 1
Coding and Documentation, Revenue Integrity

Review the rules and put your knowledge to the test with these exercises for applying moodier -JW.

Get Your Coding Right the First Time—Prior to Billing—with Automated Analysis from eValuator

Thu, 12/02/2021 - 18:20
White Papers
Billing and Claims, Coding and Documentation, Revenue Integrity

Optimized financial performance starts with accurately coded claims, yet far too many providers only review a small portion of cases prior to billing. This means the majority of the issues behind revenue leakage...

AMA: New codes created for COVID-19 vaccine boosters

Wed, 11/10/2021
Revenue Integrity Insider
Chargemaster and Charge Capture, Coding and Documentation, News, Revenue Integrity

The AMA updated its Current Procedural Terminology (CPT®) code set to add a new code for booster doses of Johnson & Johnson’s (J&J) COVID-19 vaccine.

2022 OPPS final rule doubles down on price transparency penalties

Wed, 11/03/2021
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, News, Reimbursement and Payment Methodologies, Revenue Integrity

The 2022 Outpatient Prospective Payment System (OPPS) final rule finalizes major changes to enforcement of CMS’ hospital price transparency requirements, among other changes.

2022 MPFS final rule revamps split/shared visit billing, expands telehealth

Wed, 11/03/2021
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

The 2022 Medicare Physician Fee Schedule (MPFS) final rule ushers in significant changes to billing for split/shared visits, telehealth coverage, and more.

ED facility levels and critical care (October 21, 2021)

Submitted by jfitzgerald@hcp... on Thu, 10/21/2021 - 16:03

ED facility levels and critical care

  • Caroline Znaniec, Managing Director, CohnReznick LLP’s Healthcare Advisory Practice, Baltimore, Maryland
  • Marie Garcia, System Manager Revenue Integrity – Charge Capture, CommonSpirit Health, Phoenix, Arizona
  • Christian S. Gabriel, National Director of Revenue Integrity at CommonSpirit Health, Glendale, California           

AMA releases CPT codes for pediatric COVID-19 vaccine

Wed, 10/13/2021
Revenue Integrity Insider
Chargemaster and Charge Capture, Coding and Documentation, News, Revenue Integrity

The new CPT® codes will become effective if the FDA issues approval or emergency use authorization for Pfizer’s two-dose COVID-19 vaccine in children ages five to 11.

Download the October 2021 issue of the NAHRI Journal

Wed, 10/06/2021
NAHRI Journal - Volume 5, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Scout ahead for revenue integrity opportunities.

2022 OPPS proposed rule: CMS major changes and reversals

Wed, 10/06/2021
NAHRI Journal - Volume 5, Issue 4
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how major changes to regulations and reimbursement could affect your organization.

2022 MPFS proposed rule: Physician reimbursement faces steep cuts, major changes

Wed, 10/06/2021
NAHRI Journal - Volume 5, Issue 4
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Analyze the potential impact of CMS’ major proposed changes to physician reimbursement.

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