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 […]
MLN Number MM11836 Revised was released July 1, 2020 that changes the implementation date to August 3, 2020. View the MLN: https://www.cms.gov/files/document/MM11836.pdf Official instruction, CR11836, issued to MACs: https://www.cms.gov/files/document/r10205OTN.pdf
On June 30, CMS proposed to update its national coverage policy for a procedure known as transcatheter edge-to-edge repair (TEER) of the mitral valve to include patients with functional mitral regurgitation (MR). TEER is a less invasive treatment option that involves clipping together a portion of the mitral valve leaflets for patients with a condition […]
Mastering the use of modifiers is an important skill all coders should have in their toolkit. Modifiers are a critical component of coding. Using modifiers correctly can reduce the risk of lost revenue and improve audit compliance. Using modifiers incorrectly can result in lost revenue and increased claims scrutiny. In general, all coders likely already […]
When patients exit a hospital setting, there are several factors that can influence the amount of payment the hospital receives for the care provided. In addition to assignment of diagnosis and procedure codes, condition and value codes as well as patient date of birth and of course, payer contracts, the discharge disposition or discharge status […]
On May 11, 2020, the Centers for Medicare & Medicaid Services (CMS) proposed a rule that focuses the agency’s efforts on a singular objective: transforming the healthcare delivery system through competition and innovation to provide patients with better value and results. The proposed rule would update Medicare payment policies for hospitals under the Inpatient Prospective […]
According to the CDC, “Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency. Sepsis happens when an infection you already have —in your skin, lungs, urinary tract, or somewhere else—triggers a chain reaction throughout your body. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.” […]
The next episode of our audio blog “Coffee with the Coder®” is Monday, January 18, 2021. 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. If you’d like to be reminded […]