Meet your CERT contractor before it’s too late. Where your state falls on Medicare’s payment error rate ranking may determine what oversight initiatives you see come to your doorstep. For example: The Centers for Medicare & Medicaid Services’ new 2023 [...]
Former MedPAC commissioner cites agencies’ high profit margins. Home health agencies have been making a lot of noise to push back on the proposed rate cuts for 2024, and a Senate hearing has added a volume boost. Background: HHAs and [...]
Hospices are enjoying a well deserved break from dramatic payment or policy changes in the 2019 final rule. But the regulation does include a number of Hospice Compare revisions that could shake up providers’ quality programs. Check out these changes [...]
Making CAHPS measures a year more recent would cut 20% of agencies off public display. The 2019 hospice final rule may not contain dramatic payment or policy changes compared to recent years, but it does include a number of Hospice [...]
Question: In our ASC, we are have seen some denials for our 66982 claims. Could you walk us through the proper use of this code? Georgia Subscriber Answer: The code you mention is 66982 (Extracapsular cataract removal with insertion of [...]
An 8.8% profit margin is still too high, Medicare watchdog says. While you may feel Medicare is swinging toward drastically underfunding home care services, a powerful voice in CMS’s ear feels the opposite — and the feds appear to be [...]
While health care providers continue to report positive results with ICD-10 claim submissions, the proof is in the results from claims processors, which appear to echo the successful sentiments. This week, revenue cycle management solution provider Relay Health Financial shared [...]
Plus: CMS reminds practices that OIG is still using analytics software to find errors. While health care providers continue to report positive results with ICD-10 claim submissions, the proof is in the results from claims processors, which appear to echo [...]
Question: A 55-year-old male undergoes Cardiac pacemaker revision only. His reports do not reveal the presence of any comorbidities as such. What DRG shall be suitable for the patient? Mississippi Subscriber Answer: The patient underwent cardiac pacemaker revision only, without any replacement [...]
Focus on 6-month prognosis, MAC urges. Be sure your claims for hospice patients with two nutrition conditions are up to snuff, because one Medicare Administrative Contractor is taking a closer look at them. “Our Medical Review Department will be initiating [...]
