CMS seeking volunteers for final round of ICD-10 end-to-end testing
by Jaclyn Fitzgerald, Editor CMS recently extended the deadline for providers to volunteer for ICD-10 end-to-end testing through May 22. The final round of ICD-10 end-to-end testing with Medicare...
View ArticleHospital starts team home visits to reduce readmissions
Paying a visit to patients in their homes can help keep them out of the hospital, according to Valley Health System in Ridgewood, New Jersey.The health system recently began a program that sends...
View ArticleQ&A: Why do we receive an edit when reporting fluoroscopy?
Q: We have started receiving an edit for our pain management procedures reported with CPT® codes 62310 (injection of diagnostic or therapeutic substances, not including neurolytic substances, including...
View ArticleQ&A: Is there a C code for sinus stents?
Q: We are have a debate about reporting sinus stents. Specific HCPCS C codes represent non-coronary stents, but we are unsure if we should be reporting a C code for the sinus stents. They are called...
View ArticleCareless actions can get you fired when it comes to HIPAA
The University of Iowa fired a student health center employee earlier this year for violating the privacy of a pregnant female student and her boyfriend, a well-known student-athlete, when the employee...
View ArticleHelping case managers boost their knowledge
Case managers today have to know a lot. They not only need the skill to work with patients effectively, but they also have to be up on the latest rules and regulations related to everything from...
View ArticleQ&A: What are biosimilar products?
Q: We are receiving requests from our physicians regarding administration of a new drug: biosimilar filgrastim. We haven’t seen anything about a code for reporting this drug and we assume that the...
View ArticleStudy identifies ways to reduce readmission risks among heart patients
Looking for a better way to gauge readmission risk? University of Texas (UT) researchers say they’ve found a way to spot which congestive heart failure patients are most likely to wind up back in the...
View ArticleQ&A: Which new HCPCS codes are effective July 1?
Q: You previously wrote about new code Q5101 for Zarxio®. Are there any additional HCPCS codes already released for use beginning July 1? A: Yes, CMS released three additional HCPCS codes that are...
View ArticleThe perils of cut-and-paste documentation
It may sometimes seem easier for a physician to grab a block of prewritten text and paste it into a patient record. But while this quick cut-and-paste may shave a few minutes off initially, it can...
View ArticleQ&A: Did CMS update pass-through devices in July’s quarterly update?
Q: Are there any new pass-through devices or changes for July under the OPPS? A: CMS has published one new pass-through device category and one change to an existing pass-through device. HCPCS code...
View ArticleLow-income patients tuning in to digital solutions
Got apps? Case managers and other health professionals are increasingly turning to digital tools to help support patients after they leave the hospital. Digital technologies have been used for...
View ArticleQ&A: Claims for hyperbaric oxygen therapy rejected
Q: We have been receiving rejections of our claims with HCPCS code C1300 (hyperbaric oxygen under pressure, full body chamber, per 30-minute interval). We have not found a replacement code. A: CMS...
View ArticleQ&A: Requirements for drug panels ordered in the ED
Q: When a patient presents to the ED and the physician there orders a drug panel, we perform the entire panel. Is that physician supposed to only order the tests for drugs that he or she suspects the...
View ArticleLow-income patients tuning in to digital solutions
Got apps? Case managers and other health professionals are increasingly turning to digital tools to help support patients after they leave the hospital. Digital technologies have been used for...
View ArticleCMS continues packaging, tweaks 2-midnight rule in 2016 OPPS final rule
By Steven AndrewsCMS is sharply accelerating its push toward moving outpatient payments from a fee-for-service model to a true prospective payment system with a number of its proposals in the 2016 OPPS...
View ArticleTips and tricks to help get along with physicians
Your relationship with the physicians you work with might be challenging from time to time. Case managers and physicians aren’t always on the same page.“Even though both groups want what is best for...
View ArticleAssociate Director’s Note: AMA, CMS join in ICD-10 education initiative
Those following the episodic turns of the ICD-10-CM/PCS implementation saga witnessed another dramatic plot twist in the narrative this week when the American Medical Association (AMA) and CMS made a...
View ArticleQ&A: New codes receive pass-through status
A: CMS did grant pass through status for three drugs, beginning July 1. The three codes are: C9453, injection, nivolumab, 1 mgC9454, injection pasireotide long acting, 1 mgC9455, injection, siltuximab,...
View ArticleCMS continues packaging, tweaks 2-midnight rule in 2016 OPPS proposed rule
By Steven AndrewsCMS is sharply accelerating its push toward moving outpatient payments from a fee-for-service model to a true prospective payment system with a number of its proposals in the 2016 OPPS...
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