August 1, 2019
Briefings on APCs

Even if a hospital is not a teaching hospital, it may have services that require National Clinical Trial (NCT) reporting. It is logical for revenue integrity leadership to own this issue, but an explanation of the requirements for NCT reporting should be shared with all staff within the revenue cycle so there is a better appreciation of the fact that clinical trial billing rules apply more broadly than merely just to research or clinical trial studies.

July 30, 2019
News & Insights

CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, while also asking for comments on how to potentially undo its policy that reduced payments for drugs purchased under the 340B drug discount program by nearly 30%.

July 29, 2019
News & Insights

New York’s statewide sepsis protocols appear to be working, according to a new study in the Journal of the American Medical Association (JAMA).

July 29, 2019
News & Insights

CMS recently announced that it updated the national coverage policy for transcatheter aortic valve replacement (TAVR), requiring covered hospitals and physicians to begin or maintain a TAVR program and adhere to updated volume requirements.

August 2, 2019
News & Insights

The January 1, 2020, deadline for reporting Appropriate Use Criteria (AUC) for advanced diagnostic imaging is fast approaching—but organizations can’t wait until the new year to prepare.

July 22, 2019
News & Insights

Clinical researchers at Johns Hopkins Hospital in Baltimore, Maryland, developed and tested a modified version of the Team Strategies and Tips to Enhance Performance and Patient Safety debriefing tool in a multidisciplinary urban emergency department (ED). They found that the tool was helpful in identifying safety threats and opportunities for performance improvement.

July 1, 2019
Briefings on APCs

In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.

July 1, 2019
Briefings on APCs

Before starting an ambulatory or outpatient CDI program, those tasked with the project must first create some universal definitions so everyone is on the same page and speaking the same language.

July 3, 2019
News & Insights

Anne Arundel Medical Center in Annapolis, Maryland, will pay $3,154,000 to settle allegations that it submitted false claims to Medicare for medically unnecessary evaluation and management services and separately billing bundled procedures

July 1, 2019
Briefings on APCs

CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.

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