In CMS
Jan 21st, 2019
Intermountain Healthcare wants the Supreme Court to weigh in on if the False Claims Act’s (FCA) provisions for whistleblowers violates the Constitution. This could affect compliance efforts across healthcare. Medical Judgment No FCA Sanctuary The issue arose last summer when the US Court of Appeals for the Tenth Circuit ruled that medical judgment can’t be ...
In CMS
Jan 21st, 2019
 The Department of Health and Human Services (HHS) have issued new guidance  for healthcare organizations to manage cyberattacks.  This is the end result of the 2015 Cybersecurity Act to align the healthcare security practices. Cybersecurity Guidance Starter Kit HHS is marketing the guidance as a starter kit for both those who are IT and non-IT ...
In CMS
Jan 18th, 2019
There has been ongoing debate about how to code complex repairs versus tissue transfers and rearrangements. Correct coding requires an understanding of the two surgical approaches. In the latest update to the National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services, the Centers for Medicare & Medicaid Services (CMS) clarifies its definition of these ...
In Billing
Jan 16th, 2019
The Centers for Medicare & Medicaid Services (CMS) has released 15 corrections to the 2019 HCPCS Level II code set, all retroactive. Of the 15 codes, five are added, one discontinued, and seven reflect changes to payment or coverage status. One modifier introduced in 2011 CMS ruefully admits was “removed in error” and is reinstated. ...
In CMS
Jan 15th, 2019
Every year, the Centers for Medicare & Medicaid Services (CMS) updates their Designated Health Services (DHS) Code List. What are designated health services, and why should you care? The Link to Designated Health Services and the Law By law, CMS categorizes the following as designated health services: Clinical laboratory services Physical therapy services Occupational therapy services ...