Making COVID-19 waivers permanent would be a start, expert says. Medicare is saying all the right words when it comes to lightening providers’ regulatory load, but will it actually make a difference for home health and hospice agencies? The Centers [...]
MFCUs recover more than $6 for every $1 spent on enforcement activities. Sometimes Medicare fraud cases get all the headlines, but the feds are focusing on Medicaid enforcement too. In its recently released strategic plan for 2020-2025, the HHS Office of [...]
More than 32 million patients have had their data compromised. If you thought 2018 was a busy year for healthcare hackers, think again. If current data breach trends continue, 2019 will be one for the ages. Background: Breach statistics suggest [...]
Good news: In many cases, you’re shifting from a temporary code. The Centers for Medicare and Medicaid Service (CMS) released a bunch of new, revised, and deleted Healthcare Common Procedure Coding System (HCPCS) codes relevant to oncology practices. How to [...]
Data Items Caution: Some items will be only partially gone. The Centers for Medicare & Medicaid Services has finalized changes to 33 OASIS items that would result in the collection of 235 fewer data elements at specific time points within [...]
Gear up for new quality measures in 2020. In addition to the payment-related provisions, the 2018 HH PPS final rule contained changes in other areas including: Value-Based Purchasing. The Centers for Medicare & Medicaid Services finalized two of its VBP [...]
Question: If our oral surgeon is looking at managing a lesion but documentation does not specify whether the lesion is benign or malignant, should I choose the diagnosis as neoplasm of uncertain behavior and a neoplasm of unspecified nature? New Jersey [...]
Document site to choose the proper code. You’ve read about ICD-10 coding for benign colon polyps in these pages before (Pathology/Lab Coding Alert Vol. 15, No. 11, “Answer ‘Where?’ for Adenomatous Colon Polyps”), but what about cancerous polyps? Here’s a [...]
Hold claims in case pathology report confirms uncertain diagnosis; differentiate ‘uncertain’ vs ‘unspecified.’ You may not always be able to narrow down your coding to a definitive code and may have to turn to “uncertain” or “unspecified” codes. Make sure [...]
There’s a difference between “uncertain” and “unspecified”ICD-9 codes — and understanding it can mean success for your coding. If a lesion is non-malignant, it’s good news for the patient — but it may be bad news for the coder if [...]
