Webinar “Collecting the Clues to Support Medical Necessity for Sepsis” Thursday, June 2nd

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Sepsis, the Conundrum that keeps on giving! Are you experiencing denials or frustrations with payers related to protocols and medical necessity for your sepsis admissions?  Listen in as the coder and clinical consultant discuss the recent challenges  and solutions related to sepsis reporting. Part 2 will focus on admission protocols, denials and appeals. Our goals […]

Listen to “Coffee with the Coder” on Monday

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The next episode of our audio blog “Coffee with the Coder®” is Tuesday, July 5th, 2022. CWTC features expert coders answering interesting (or popular) questions. Designed to take less time than a coffee break, CWTC is the conference call you don’t want to miss. And it’s FREE to listen. (717) 908 1834 access code 772888# […]

OPPS Proposed Rule FY 2022

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Medicare Program:  Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Price Transparency of Hospital Standard Charges; Radiation Oncology Model; Request for Information on Rural Emergency Hospitals This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for […]

Physician Fee Schedule Proposed Rule 2022

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CMS Proposes Physician Payment Rule to Improve Health Equity, Patient Access Rule Would Expand Access to Telehealth Services, Enhance Diabetes Prevention Programs The Centers for Medicare & Medicaid Services (CMS) is proposing changes to address the widening gap in health equity highlighted by the COVID-19 Public Health Emergency (PHE) and to expand patient access to […]

Physician Fee Schedule CY2021

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This final rule updates policies affecting the calculation of payment rates and includes misvalued codes. It also adds services to the telehealth list including a third temporary category for services added under the PHE, as well as certain other revisions to telehealth services. It also addresses direct supervision as it relates to interactive technology, payment […]

AMA Announces new COVID-19 vaccine CPT® codes

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The American Medical Association (AMA) announced that the Current Procedural Terminology (CPT®) code set is being updated by the CPT Editorial Panel to include immunization and administration codes that are unique to the COVID-19 vaccine under development by AstraZeneca and University of Oxford. The new CPT codes will be effective for use on the condition […]

CY2021 Physician Fee Schedule Proposed Rule

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CMS issued a proposed rule on August 3, 2020, on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2021. This document is scheduled for publication in the Federal Register on August 17, 2020 Background on the Physician Fee Schedule Since […]

OPPS Proposed Rule CY2021

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On August 4, 2020, the CMS proposed policies that aim to increase choice, lower patients’ out-of-pocket costs, empower patients, and protect taxpayer dollars. These proposed changes would build on existing efforts to increase patient choice by making Medicare payment available for more services in different sites of service and adopting policy changes under the Medicare […]

CY2021 ESRD Proposed Rule

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On July 6, CMS issued a proposed rule that proposes to update payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2021. This rule also proposes updates to the Acute Kidney Injury (AKI) dialysis payment rate for renal […]