Knowing which services are included and which are separately reportable ensures appropriate reimbursement. By Cindy Hughes, CPC, CFPC In the first years of life, preventive services play an important role in determining if a child is growing and developing as expected. And for these services, payer rules play an important role in being reimbursed appropriately. ...
Jul 28th, 2017
The Centers for Medicare & Medicaid Services (CMS) announced today the release of a Pediatric measure set as part of the Core Quality Measures Collaborative (CQMC). The Pediatric measure set includes nine measures for use at the provider level for solo providers or provider groups. Seven of the nine measures coincide with existing state-level measures ...
In MACRA
Mar 22nd, 2017
Section 3021 of the Affordable Care Act gives the Center for Medicare and Medicaid Innovation (CMMI) the authority to test alternate payment models (APMs). The goals of these APMs are to reduce program expenditures while preserving or enhancing the quality of care for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries. Pediatric Alternative Payment ...
Dec 1st, 2013
Preview what’s in store for coding in the year ahead so you aren’t caught by surprise. By Raemarie Jimenez, CPC, CPB, CPMA, CPPM, CPC-I, CANPC, CRHC It’s that time of year where surprise packages arrive at your door. Being surprised with a mailbox full of holiday cards and gifts is a treat, but also is ...
Sep 1st, 2013
Be sure pediatric ED documentation and coding reflect the demands of your specialty. By Jim Strafford, CEDC, MCS-P Emergency department (ED) coding is place-of-service driven. Coding the five ED levels (99281-99285) and critical care is governed by the American Medical Association’s (AMA) CPT® guidelines, as well as the Centers for Medicare & Medicaid Services’ (CMS) ...