News

CMS provides updates and insight during the HBMA meeting. The Healthcare Business Management Association’s (HBMA) Government Relations Committee has been extremely fortunate to be invited to meet with many CMS representatives each summer. The 2019 meeting offered many insights into issues of physician and industry concern and the CMS thoughts…
The author shares highlights from the annual conference. From May 20-23, I was in Kissimmee, Fla. with many of you at the ACDIS annual conference. It was really affirming for so many of you to come up to me and express your appreciation for Talk-Ten-Tuesdays. It’s nice to know there…
Big ICD-10 changes coming soon to the SNF world. In July 2018, the Centers for Medicare & Medicaid Services (CMS) finalized a new case-mix classification model, the Patient-Driven Payment Model (PDPM), which, effective beginning Oct. 1, 2019, will be used under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS)…
How to enhance edits to achieve clean claims. The effective use of edits within a healthcare organization’s billing system may permit such organizations to not only identify documentation, billing, and coding issues to address, but also facilitate achieving an improved clean claim rate. A clean claim is one that meets…
The public comment period closes June 24, 2019.Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced its proposed rule changes for Inpatient Prospective Payment System (IPPS) rates and Medicare payment policies. The rule will be finalized in September, and CMS is currently accepting public comments until June…
Is your data as secure as you assume it to be? I recently saw an image on the Internet depicting the iconic “cloud.” Under it, the caption read “there is no cloud; it is just someone else’s computer.”  I want to let that sink in, and get past the humor…
New billable CPT® codes for monitoring patients who are taking blood-thinning medications. In 2018, CPT® deleted codes 99363 and 99364 and replaced them with codes 93792 and 93793. There are two important things to know about coding for international normalized ratio (INR) monitoring, also known as a “protime check” (PT).…
Final ICD-10-PCS codes for FY 2020 are here. The Centers for Medicare & Medicaid Services (CMS) released the final FY 2020 ICD-10-PCS codes on May 31. This included a total of 77,559 procedure codes for the MS-DRG V37.    The changes include 734 new codes, 2,056 deleted codes, and two…