CMS proposed a number of outpatient prospective policies in the calendar year (CY) 2017 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System policy changes, quality provisions, and payment rates proposed rule, released by the agency on July 6...Read More »
CMS released the 2017 Medicare Physician Fee Schedule (MPFS) proposed rule yesterday, with policies that look to expand an Innovation Center program, revise payment for care management services, and collect data regarding global period payments.Read More »
Q: I am never sure of correct sequencing when the admission is for flu, pneumonia, and asthma.The patient presented in the emergency department (ED) with shortness of breath, still tight after nebulizer treatment in the emergency room. The patient was kept for observation for...Read More »
There are 1,974 additions, 311 deletions, and 425 revisions for the 2017 ICD-10-CM code set, according to a statement published by CMS. The resulting total of 71,486 diagnosis codes was released by the Centers for Disease Control and Prevention (CDC) on June 24.Read More »
The fiscal year (FY) 2017 IPPS proposed rule included some significant changes to Patient Safety Indicator (PSI) 90, one of which is a new name: The Patient Safety and Adverse Events Composite. A fact sheet recently released by the measure's owner, the Agency for Healthcare Research and Quality...Read More »
Q: I am with a CDI program that is starting to explore the severity of illness/risk of mortality (SOI/ROM). I personally have been reviewing for SOI/ROM for quite a while. I usually designate the impact (MCC/CC/SOI/ROM) after the billing is done and see if what I queried for...Read More »
One size does NOT fit all when it comes to health insurance. Beneficiaries range from the extremely healthy 65-year-old—the poster child for “65 is the new 45”—to a 65-year old suffering from COPD from a lifetime of smoking, cancer, and a hereditary condition such as Type 1 diabetes. The result...Read More »
The American Hospital Association (AHA) is concerned about the documentation and coding reduction, changes to disproportionate share hospital (DSH) payments, and the implementation of many of CMS’s quality programs detailed in the CMS IPPS Proposed Rule for Fiscal Year (FY) 2017, according to a ...Read More »
