Q: Our clinical trial claims often hit edits for missing drugs or devices when those are supplied by the trial sponsor and we can't bill for them. We've been manually reviewing these edits. Is there a recommended method for handling these types of edits that's more efficient?
Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.
On June 11, CMS published a Request for Information (RFI) as part of its Patients Over Paperwork initiative to collect public input on ways to reduce unnecessary administrative and regulatory burden.
CMS initiated an Annual Call for Measures in 2019 to allow eligible hospitals and critical access hospitals to submit proposals for new measures to be included in the Medicare Promoting Interoperability Program under the IPPS.
Having taken on more diverse responsibilities, many providers regard medical coding as a necessary evil; their primary focus is caring for their patients. Although many physicians select codes for the work they perform, they rely on specialized coding and auditing professionals to review their documentation and reporting for accuracy.
Put CMS’ proposed changes in perspective to see the bigger picture. Comments are due June 24, so hospitals will need to conduct a careful analysis to determine the impact of the proposed changes and submit specific feedback.
