2014 OPPS Final Rule Outcome for Collapse of E/M Levels

For 2014 CMS has finalized the collapse of the clinic visit codes. They have opted to not include Type A or B ED visits at this time. The national reimbursement rate for G0463 under APC 0634 is $92.53. CMS will continue to explore the ED visits and address in future rule making. For now, hospital … [Read More]

How Do Hospitals Operationalize the Two Midnight Rule?

Patient status is not new, the Medicare defined outpatient, observation and inpatient status has been in place for many years. This rule is to help practitioners and facilities identify and document the physician’s decision to have the patient treated in an outpatient (observation) or inpatient status. Operationally, the provider takes into account the patient’s history, … [Read More]

New Patient Discharge Status Codes

There are 16 new discharge status codes which went into effect 10/1/13.  At this time, they apply only to MS-DRGs 280 (Acute Myocardial Infarction, Discharged Alive with MCC), 281 (Acute Myocardial Infarction, Discharged Alive with CC), 282 (Acute Myocardial Infarction, Discharged Alive without CC/MCC) and 789 (Neonates, Died or Transferred to Another Acute Care Facility). … [Read More]

Meaningful Use Audits

CMS Meaningful Use audits are on the rise. Ensuring that a facility qualified for bonus payments may be an uphill battle if there is no proof of documentation supporting the Meaningful Use and clinical quality measure data submitted during attestation. CMS initiated Meaningful Use audits in July 2012, now consisting of both pre- and post- … [Read More]

2014 CPT / OPPS Update Webinar – Part 1

This webinar covers the E/M through Surgical Cardiology sections of CPT.  (Duration 1 hour) Register below to view recorded webinar Part 1: https://www1.gotomeeting.com/register/245974288 Download handouts/presentation PDF: 2014 CPT OPPS Update Part I Handouts_3up 2014 CPT OPPS Update Part I Handouts_2up 2014 CPT OPPS Update Part I 2014 CPT / OPPS Update Webinar – Part 2 … [Read More]

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