FY 2014 IPPS Final Rule Released

On August 2, the Centers for Medicare and Medicaid Services (CMS) released the Medicare inpatient prospective payment system (IPPS) final rule for fiscal year 2014.   Coding Update The ICD-9-CM Coordination and Maintenance Committee implemented a partial freeze of ICD-9-CM prior to the implementation of ICD-10 on October 1, 2014. The last regular annual updates … [Read More]

More News on the Horizon for OPPS Proposed Rules

Should all these proposals take effect next year, everyone is in for a huge shift in thinking for billing and reimbursement. We have always encouraged reporting all chargeable procedures, supplies and medications that represent the full economic value of a patient’s encounter. This is not going to change; however, the reimbursements will should these proposed … [Read More]

OPPS Proposed Updates Released July 8, 2013

Just in case you haven’t had a chance to get into the Federal Register and review the proposed changes; here are a couple of the highlights. The Centers for Medicare & Medicaid Services (CMS) are proposing a collapse of hospital outpatient clinic and ED visit codes instead of recognizing the current five levels of clinic … [Read More]

Is it Medically Necessary?

If so, can you prove it? Documentation is the key to payment for services rendered. We have heard it time and time again. As coders we have to be cautious and precise with our coding decisions in order to stay compliant and assign codes to the highest level of specificity gleaned from the documentation. This … [Read More]

Half Way Through 2013

As we approach the midpoint of 2013 and attempt to carve out time for all that is required of us, both personally and professionally, here are a few thoughts:  In sixteen months the most significant change in revenue management will occur with the conversion to ICD-10.  Although we expect that most coding teams have a … [Read More]

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