Do you and your team have a good process to readily identify and bill appropriately for self-administered drugs? The Centers for Medicare & Medicaid Services (CMS) has had a longstanding policy excluding self-administered drugs (SADs) under the outpatient Part B benefit. Oral drugs, suppositories, and topical medications, for example, are easy enough to identify as […]
Compliance plans are critical to making sure your organization is mitigating risk. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recommends that you audit a minimum of 10 professional encounters per year, per physician – but if you’re not going above and beyond that by performing focused audits, you’re […]
The chaos and confusion fomented throughout the American healthcare industry by the continuing COVID-19 pandemic has been bad enough in of itself – but when coders found themselves unable to accurately document what was even going on with patients, things got even worse.
Following the recent unveiling by federal officials of the 2021 Outpatient Prospective Payment System (OPPS) Final Rule, Panacea Healthcare Solutions has created a comprehensive Final Rule Summary highlighting some of the most salient looming changes facing healthcare providers nationwide.
Our revenue integrity team continually monitors announcements by the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) to bring you the most current and up-to-date coding and billing information. Since our last quarterly update, CMS and AMA have been actively publishing new information that hospitals and providers will need to […]
Panacea’s consultants have been closely monitoring both Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) published guidance for newly created codes for billing during the COVID-19 public health emergency (PHE). Since February 2020, there have been many new codes added for COVID testing and specimen collection.
On July 28, 2020, CMS released a new FAQ for Hospital Billing for Remote Services (Section LL) and expanded the FAQ for Outpatient Therapy Services (Section MM) in the COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document.
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Over the last several months we’ve seen an uptick in requests from clients nationwide for help reconciling laboratory orderables to chargemasters. In case you’re in this same boat, we wanted to provide some insight into the steps you should be taking.
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Coding and Billing Resources for Coronavirus COVID-19 Important information that provides current coding and billing updates from all of the regulatory agencies for our clients and the provider community during this public health emergency (PHE). We will continue to update this page as new guidance is received and reviewed by our senior healthcare consultants.