Compliance and auditing offer an opportunity for continuous improvement. Done right they help organizations better serve patients, mitigate risk and exposure, and improve reimbursement and revenue. But what constitutes doing it right? This article discusses the three most common mistakes.
Ask Kathy Pride, and she’ll tell you: there are two ways for healthcare providers to perform proactive auditing of their claims. There’s the old way—and there’s the better way. The […]
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 […]
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 […]
Typically, we would have the Final Rule updates to the Inpatient Prospective Payment System (IPPS) for the 2021 fiscal year (FY) 60 days prior to its effective date. However, this year, citing the COVID-19 public health emergency (PHE), publication was delayed. The final rule was published on September 1, or 30 days before the effective date.
On August 4, the Centers for Medicare & Medicaid Services (CMS) released the Changes to Hospital Outpatient Prospective Payment System (OPPS) for the 2021 calendar year (CY). The proposed regulations were published in the Federal Register on August 12, and comments are due by October 5.
Beginning July 1,2020 Medicare required prior authorization for five procedure classes: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. As a reminder, prior authorization was announced through the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (CMS-1717-FC).
I’m sure everyone has heard the saying, “the only constant is change.” Well, it certainly rings true these days. The Centers for Medicare & Medicaid Services (CMS) issued a second interim final rule on April 30, offering another round of coding and documentation updates related to telehealth during the public health emergency.
Panacea has summarized the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) payment and coding updates, effective July 2020 (with some retroactive changes). Please review the updates for possible implementation in your hospital chargemaster and/or review by applicable department, coding and billing staff.
As many of you have heard, there are major changes coming to evaluation and management (E&M) codes in 2021. The changes were finalized in the 2020 Physician Final Rule.