News & Analysis

February 14, 2017
News & Insights

A recent JAMA study analyzed the proportion and cost of 30-day readmissions and found that sepsis accounts for a higher rate of unplanned readmissions than acute myocardial infarction (AMI), heart failure, pneumonia, and chronic obstructive pulmonary disease (COPD). CMS uses 30-day readmission rates as a measure of quality of care and pays particular attention to AMI, heart failure, pneumonia, and COPD readmissions because they are frequent and costly.

February 14, 2017
News & Insights

Is modifier -PN used instead of or in addition to modifier -PO in a non-excepted department? Do we still need to add modifier -PO in general?

February 13, 2017
Medicare Insider

This week’s Medicare updates include Advance Care Planning implementation for OPPS claims, revision to State Operations Manual Appendix PP - incorporating revised Requirements of Participation for Medicare and Medicaid certified nursing facilities, and more!

February 13, 2017
Briefings on HIPAA

HIPAA privacy and security professionals work hard to create commonsense policies and procedures and lobby for the best technical safeguards for their organizations. But time and again that hard work is wiped out by the most persistent threat of all: insider threat.

February 13, 2017
Medicare Insider

This week's note from the instructor discusses the billing challenges presented by CMS' Medically Unlikely Edits.

February 10, 2017
Case Management Monthly

Looking to get an ACM™ certification? In December, the American Case Management Association (ACMA) and National Board for Case Management (NBCM) announced a change to the exam eligibility requirements that may be of interest to those looking to earn ACM certification. The NBCM now allows applicants with at least one year of full-time supervised work experience to sit for the ACM-RN (Registered Nurse) and ACM-SW (Social Work) exams. Prior to this change, candidates had to have at least two years of case management experience before they could take either exam.

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