Q&A: Is CMS going to start accepting new Category III CPT(registered trade...
Q: Is CMS going to start accepting new Category III CPT® codes for July? A: The AMA releases Category III CPT codes in January and July each year. The codes released in January are effective the...
View ArticleOCR issues breach and compliance reports to Congress
by Jaclyn Fitzgerald, Editor OCR recently sent two annual reports to Congress that summarize 2011–2012 HIPAA breach and compliance activities as required by the HITECH Act. OCR received 236 reports...
View ArticleNew legislation aims to expand homecare options for Americans with disabilities
Senator Tom Harkin (D-Iowa) recently introduced new legislation to broaden the scope of home- and community-based service options for Americans living with disabilities—a move that commemorates the...
View ArticleCMS reintroduces Comprehensive APCs, proposes expanded packaging
The 2015 OPPS proposed rule, released July 3 by CMS, is relatively short at less than 700 pages, but contains refinements to the previously introduced Comprehensive APC policy, significant packaging of...
View ArticleLTC providers will be able to appeal Medicare claims without ALJ
Long-term care providers will be able to appeal certain Medicare claims decisions without utilizing an administrative law judge, the Centers for Medicare & Medicaid Services announced...
View ArticleQ&A: Has CMS introduced a new modifier for billing separately payable lab...
Q: Has CMS released further guidance on billing lab tests under the OPPS for separate payment? Do we continue to split them off onto a 141 bill type? This is causing a lot of process issues for us. A:...
View ArticleDOJ and HHS release roadmap to combat elder abuse
The Department of Justice (DOJ) and the Department of Health and Human Services (HHS) recently released a new tool intended to help care providers, policy makers, educators, and researchers prevent and...
View ArticleCMS releases 2015 OPPS proposed rule
by Jaclyn Fitzgerald, Editor CMS recently released its 2015 OPPS proposed rule, which includes proposed changes to the Comprehensive APC policy, packaging of ancillary services, and inpatient...
View ArticleCBO announces Medicare and Medicaid spending growth at slower rate
Medicare and Medicaid spending will grow at a slower rate than past predictions indicated, the Congressional Budget Office stated Tuesday. However, an aging population will put increasing pressure on...
View ArticleQ&A: Our payments for some separately reportable drugs change
Q: Why do the payments for some separately payable drugs change? One week we get paid a certain amount and the next week it may be different, but the units and HCPCS code are the same. We tend to see...
View ArticleHIMSS updates ICD-10 resources
by Jaclyn Fitzgerald, EditorThe Healthcare Information and Management Systems Society (HIMSS) recently updated its ICD-10 PlayBook to help organizations revamp their ICD-10 planning strategies in light...
View ArticleNew bill would delay employer mandate for certain Medicare, Medicaid providers
Representative Steve Daines (R-Montana) recently introduced legislation that would delay the employer mandate provision of the Affordable Care Act (ACA) until January 1, 2016 for businesses that offer...
View ArticleNQF supports quality measures to standardize post-acute assessments
The National Quality Forum has come out in strong support of a proposed standardized quality measures, such as skin integrity, across different types of post-acute care settings. Uniform assessments...
View ArticleQ&A: Updates to drugs with pass-through status
Q: Did any new drugs receive pass-through status July 1? A: Yes, CMS granted three drugs and biologicals pass-through status beginning July 1, 2014. These are listed in Transmittal 2971, along with the...
View ArticleCMS issues new guidance for clinical decision support interventions
by Jaclyn Fitzgerald, Editor CMS recently issued new FAQ guidance about which interventions EHRs must trigger to meet the criteria for Medicare and Medicaid EHR Incentive Program’s clinical decision...
View ArticleIMPACT Act introduced in House
On Saturday, the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (H.R. 4994) was introduced in the House of Representatives and subsequently referred to both the Committee on...
View ArticleICD-10 compliance date officially set for October 1, 2015
HHS will release the final rule, Administrative Simplification: Change to the Compliance Date for the International Classification of Diseases, 10th Revision (ICD–10–CM and ICD-10-PCS) Medical Data...
View ArticleQ&A: Why do we need to report the amount of contrast used?
Q: We just underwent an audit and the auditor took charges off the claim saying that the radiology report didn’t support the amount of contrast given. We have standard-size bottles that we use and we...
View ArticleICD-10 compliance date officially set for October 1, 2015
By Michelle A. Leppert, CPCHHS will release the final rule, Administrative Simplification: Change to the Compliance Date for the International Classification of Diseases, 10th Revision (ICD–10–CM and...
View ArticleHHS announces new ICD-10 compliance date
by Jaclyn Fitzgerald, Editor HHS is set to release a final rule in the Federal Register that will establish October 1, 2015, as the new compliance date for ICD-10. Congress passed H.R. 4302,...
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