Profit margin is down — but still too high, MedPAC insists. Policy- and lawmakers use crucial data provided by the Medicare Payment Advisory Commission to make tough budget decisions. Take a look at the 2022 home health stats MedPAC provides [...]
Learn which Medicare programs are impacted. Information blocking remains a high priority for enforcement, and a recent proposed rule aims the crosshairs on Medicare providers’ interoperability practices and the impact on incentive payments. In 2016, the 21st Century Cures Act [...]
Warning: Medicare providers are the target demographic. Since the 21st Century Cures Act was enacted in 2016, the feds have methodically executed data sharing regulations — and penalties for violations. Information blocking continues to be a top enforcement concern, and [...]
Find out which details can lead to the most specific codes. Many conditions affect the retina, from inflammation and vascular pathologies to retinal detachments and breaks. These conditions are common, and many practices that provide eye care see these problems [...]
Learn the details that lead to maximum code specificity. Retinal conditions run the gamut from inflammation and vascular pathologies to detachment and breaks. Due to their prevalence, most eye care practices see patients with such problems every day, requiring you [...]
One ophthalmologist in our sampling would lose $39,000 a year under the new proposal. Although eye care practices have the option of reporting either ophthalmological services codes or E/M codes for their patient encounters, many ophthalmologists and optometrists bill the [...]
Plus: You may not have to give up hope for the rural add-on quite yet. While the news that Medicare officials were pulling HHGM from the 2018 HH PPS Final Rule was met with universal pleasure from the home health [...]
Therapy episodes would get reimbursed less. If your claims are dominated by episodes with high therapy, no recent hospital stays, or patients with behavioral health conditions such as schizophrenia, bipolar disorder or drug addiction, Medicare’s draft for HH PPS payment [...]
Question: What is Quadrilateral Space Syndrome, and which ICD-9 code should I use to report it? Codify Subscriber Answer: Quadrilateral space syndrome (QSS) refers to the compression of the axillary nerve in the back of the patient’s shoulder. Sometimes the compression [...]
Face-to-face, plan of care and OASIS requirements continue to torpedo high-therapy claims in one Palmetto GBA edit. Palmetto reviewed 10 claims with HIPPS code 5BHK* in Illinois, Louisiana and Mississippi in its latest edit targeting the HIPPS code that represents [...]
