In Billing
Sep 13th, 2019
October 1 is a scary time for medical coders. There are fourth quarter updates to HCPCS Level II codes and code editors. Payment system and fee schedules are updated. And ICD-10-CM code changes go into effect. What’s a coder to do? Whatever you do, don’t hide under your bed. Jason’s under there (just a little Friday ...
In Billing
Mar 28th, 2019
With or without a rhyme or reason, you can count on coding changes popping up throughout the year. In addition to April updates to the Medicare Physician Fee Schedule (PFS), providers billing under the Outpatient Prospective Payment System (OPPS) should be aware of four new CPT codes, a new advanced diagnostic laboratory test, additions to ...
In Coding
Feb 27th, 2019
Meet outpatient quality reporting requirements or prepare for a payment reduction. Using Hospital Outpatient Prospective Payment System (OPPS) methodology, the Centers for Medicare & Medicaid Services (CMS) based 2019 OPPS payments on 2017 claims data submitted by hospital providers, resulting in an estimated 1.35 percent increase. Hospitals that fail to meet the hospital outpatient quality ...
In CMS
Nov 5th, 2018
Utilization, new codes, device pass-through, and 340B payment policies top the changes in the Centers for Medicare & Medicaid Services’ (CMS) Outpatient Prospective Payment System (OPPS) final rule for 2019. Cutting OPPS Costs CMS said in a fact sheet with the long-winded title of “CMS finalizes Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical ...
In Audit
Aug 21st, 2018
An OIG review shows Medicare overpaid outpatient hospitals as much as $25.8 million for complex simulations billed during audit period. Between 2013 and 2015, Medicare paid 1,193 hospitals $109,197,933 in bundled payments for intensity modulated radiation therapy (IMRT) — about $25,754,171 more than they should have, according to the Office of Inspector General (OIG). The ...