New codes and updates for outpatient skin substitute claims

Wed, 10/23/2024
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Revenue Integrity

CMS added new Healthcare Common Procedure Coding System (HCPCS) codes and made status indicator (SI) and code descriptor changes for outpatient skin substitute claims.

CMS issues PrEP NCD

Wed, 10/09/2024
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Coverage, News

CMS recently issued a final national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) using antiretroviral drugs to prevent HIV in high-risk individuals.

Download the October 2024 issue of the NAHRI Journal

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Set the stage for success and close out the year strong.

Different payment policy rationale in different CMS rules raises serious questions

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Coding and Documentation, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Jugna Shah, MPH, CHRI, highlights the need for Medicare payment policy changes.

2025 IPPS final rule calls for a TEAM effort

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how to ensure your organization is in compliance with CMS’ newest rules.

Putting the 2025 OPPS proposed rule under the microscope

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at major changes in the works for outpatient reimbursement.

New CAR-T codes

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

Review proposed changes to coding and reimbursement for chimeric antigen receptor T-cell (CAR-T) services.

Navigating the 2025 MPFS proposed rule

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes could impact your organization.

Staying up to date with NCCI edits

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Coding and Documentation, Compliance, Monitoring and Audits, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Review recent changes and compliance tips for NCCI edits.

2024 ACDIS/NAHRI Denials Management Mastermind Recap

Thu, 09/26/2024 - 09:14
Webinars
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Denials and Appeals, Monitoring and Audits, NAHRI Leadership Council, Policies and Procedures, Revenue Integrity

Healthcare organizations are under more and more pressure from denials, impacting hospitals’ bottom lines and ultimately resources they have available to care for patients. Those in the revenue integrity and clinical documentation integrity (CDI) fields are

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