The release of the Quality Payment Program proposed rule introduced virtual groups as a way to reduce burden on small practices and clinicians. While the MACRA legislation laid out the initial concept of virtual groups, this proposed rule revealed many more details about how virtual groups will function.
CMS has spoken repeatedly of easing the burden for providers this spring, and the agency’s Quality Payment Program (QPP) proposed rule released June 20 attempts to do that for small practices and other clinicians.
CMS issued SE1609 to clarify long-standing policy concerning external infusion pumps. Apparently, both freestanding physician offices and outpatient hospital departments were treating external pumps as an item of durable medical equipment, even when the physician or hospital department set up the pump on the patient, supplied the drug, and programmed the infusion rate and dose into the pump.
We have trouble billing multiple units of injections and infusions—mostly CPT add-on codes 96375 (injection, each additional sequential intravenous push of a new substance/drug) and 96376 (injection, each additional sequential intravenous push of the same substance/drug provided in a facility)—that are done during observation stays and exceed the medically unlikely edits number. What is the correct way to bill these and get paid?
I've noticed some conflicting information in CPT Assistant and NCCI edits for CPT code 29874 (knee arthroscopy with removal of loose/foreign body). Do the NCCI edits override the advice in CPT Assistant?
The 2017 calendar year marks the beginning of a new approach to physician payment through the Quality Payment Program (QPP), an initiative created by the Medicare Access and CHIP Reauthorization Act to revise the physician payment system previously updated through the Sustainable Growth Rate.
CMS has released the final 2018 ICD-10-CM codes to be implemented October 1, with hundreds of changes from the version released in the 2018 IPPS proposed rule.
When CMS introduced Hierarchical Condition Categories (HCC) with risk-adjusted scores, Ochsner Health System began efforts to educate providers and improve documentation across its many facilities.
A recent Coding Clinic has garnered a lot of questions on inpatient obstetrics coding. While coders were originally taught to use multiple codes for the repair of a third- or fourth-degree perineal laceration, Coding Clinic, First Quarter 2016, states that you don’t use multiple codes for third- and fourth-degree tears, because you need to code to the “deepest layer.” New guidance has further confused the issue.
In ICD-10-CM, defining, diagnosing, and documenting the various forms of altered mental status and their underlying causes remains an ongoing challenge for physicians and their facilities.
