CMS laid the groundwork for a dramatic revision of MS-DRG rate setting in the 2021 Inpatient Prospective Payment System (IPPS). The agency also rolled out code changes and MS-DRG updates. Ensure your organization is compliance with new requirements.
CMS continues to focus on site-neutral payment policies and keeping payments down for 340B-acquired drugs in the 2021 OPPS proposed rule, released in early August.
The American Medical Association (AMA) on September 8 published two new CPT codes for novel coronavirus (COVID-19)-related services, including one that accounts for additional supplies and clinical staff time used to mitigate spread of the virus.
Strong documentation and coding support accurate data and help organizations defend against payer audits. Learn how to manage the return of CMS audits and keep documentation and coding in top shape.
CMS is moving forward for E/M changes for physician billing according to the 2021 Medicare Physician Fee Schedule. Read about those changes, as long as a preview of new CPT codes that will be added for 2021.
Finding the right applicant to fill a vacancy in the coding department can be challenging. Organizations can help close the gap and improve their coding staff by implementing an apprentice program. Use this sample education schedule to help develop a program at your organization.
Q: As utilization review case managers, we are often tasked with assessing our hospital's risk for novel coronavirus (COVID-19) denials. What are the most important measures we should be examining?
Providers may need to keep track of two different times when reporting new CPT® add-on code 99XXX for prolonged services in 2021. CMS will not follow the time ranges that the AMA released in its guidelines for office E/M visits and prolonged services, according to the 2021 Medicare Physician Fee Schedule (MPFS) proposed rule.
Inpatient novel coronavirus (COVID-19) claims will require a positive viral test result to be eligible for the 20% increase in the MS-DRG weighting factor, effective for admissions on or after September 1.
