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CMS Dramatically Increases Penalties for Price Transparency Non-Compliance – Panacea Responds with a No-Cost Consultation

ST. PAUL, MN – With the dramatic increase in civil penalties announced by the Center for Medicare & Medicaid Services (CMS), Panacea Healthcare Solutions, Inc., the leading experts in hospital price transparency, announced that it will make its hospital, physician and pharmacy pricing senior-level consultants available to hospitals at no cost to review and make […]

Document Your Leftovers: The JW Modifier and How to Use It

On Jan. 1, 2017, the Centers for Medicare & Medicaid Services (CMS) and Medicare Administrative Contractors (MACs) began requiring the use of the JW modifier. The JW modifier is appended to applicable drug HCPCS codes to report the discarded amount of unused injectable medication from a single-dose vial. The HCPCS code and JW modifier are […]

New Modifiers: Hospital Outpatient Billing for Injectable Self-Administered Drugs

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 […]

What’s on Your 2021 OIG Compliance Greatest Hits List?

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 […]

New ICD-10 Codes Create Clarity in Capturing COVID in 2021

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.

Panacea Unveils Comprehensive Summary of 2021 OPPS Final Rule

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.

CMS and AMA Fourth Quarter 2020 Coding Updates: Panacea Summary and Recommendations

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 Special Edition / Laboratory Services Update During COVID-19 PHE

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.

UPDATE: Billing for Hospital Outpatient Services During the COVID-19 PHE

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[1].

How to Rationalize Chargemaster Prices

Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems…