CMS removes two codes from prior authorization list

Wed, 05/19/2021
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Revenue Integrity

Two CPT® codes are temporarily suspended from the prior authorization program for hospital outpatient departments, CMS announced.

Association updates, the revenue integrity value of physician advisors, and wound care coding tips on April’s Quarterly Call

Wed, 05/12/2021
Revenue Integrity Insider
Coding and Documentation, Compliance, Denials and Appeals, Program Management, Revenue Integrity

NAHRI’s April 27 Quarterly Call explored the impact of physician advisors on revenue integrity, wound care coding tips, and the latest association updates.

NAHRI Leadership Council Meeting (04-30-21)

Fri, 04/30/2021 - 14:56
Council Resources
Coding and Documentation, Denials and Appeals, NAHRI Leadership Council, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

2022 IPPS proposed rule seeks to mitigate impact of COVID-19, walks back MS-DRG overhaul

Wed, 04/28/2021
Revenue Integrity Insider
Coding and Documentation, News, Reimbursement and Payment Methodologies, Revenue Integrity

The fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) proposed rule makes broad efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. The proposed rule, released April 27, also eliminates sweeping changes to MS-DRG rate-setting finalized in the 2021 IPPS final rule.

NAHRI Quarterly Call -- April 27, 2021

Tue, 04/27/2021 - 14:38
Quarterly Calls
Coding and Documentation, Program Management, Revenue Integrity

The 2021 calls will take place at the following dates and times:

  • Tues, July 27, 2021 1:00 - 2:00 EDT
  • Tues, October 26, 2021 1:00 - 2:00 EDT
  • ...

CMS updates telehealth list, cautions organization to pay attention to billing rules

Wed, 04/21/2021
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Coverage, News, Revenue Integrity

CMS released an updated list of Medicare telehealth services while cautioning organizations to pay close attention to telehealth billing rules.

Using CMS and NAHRI resources to address charge denials

Wed, 04/07/2021
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Policies and Procedures, Revenue Integrity

Learn how to use NAHRI resources and CMS and HIPAA requirements to appeal inappropriate charge denials.

Download the April 2021 issue of the NAHRI Journal

Tue, 04/06/2021
NAHRI Journal - Volume 5, Issue 2
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Explore the revenue integrity universe.

Charting the operational impact of eliminating the IPO

Tue, 04/06/2021
NAHRI Journal - Volume 5, Issue 2
Coding and Documentation, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Understand the far-reaching financial and operational impacts of sunsetting the inpatient-only (IPO) list.

Secure success: Packaging E/M audit results

Tue, 04/06/2021
NAHRI Journal - Volume 5, Issue 2
Coding and Documentation, Monitoring and Audits, Revenue Integrity

Use these best practices to effectively present internal audit results.

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