CMS on January 27 updated coding and billing instructions to hospitals for new COVID-19 treatments add-on payment (NCTAP).

CMS suggests 1,495 total changes to the ICD-10-CM diagnosis code set in the FY 2023 IPPS proposed rule.

Q: When Correct Coding Initiative (CCI) edits for certain services do not apply under the Outpatient Prospective Payment System (OPPS), is it appropriate for a hospital to report a pair of codes ...

ICD-10 doomsday is Oct. 1, 2014, for physicians, hospitals and all other providers, and CMS is ramping up its guidance on how providers should prepare for the transition.

Shifting from reducing MA capitation by an across-the-board coding intensity adjustment factor to Medicare Advantage organization (MAO)-specific adjustment factors would improve the financial ...

Commission staff said is not a clear explanation for the coding change, but a high concentration of level 5 ED visits with the same patient conditions treated likely indicates that Medicare pays ...

The final rule includes policy changes and payment rates for services in ASCs and continues to expand the list of surgical procedures that Medicare will cover when performed in ASCs, according to the ...

Coding and documentation guidelines for E/M services were also revised for the first time in more than 25 years. These changes are significant, and they deserve a closer look.

A new bill to improve the way Medicare Advantage (MA) providers determine patients’ health risks, to eliminate overpayment.

In 2021, UnitedHealth Group received 42% of the $33 billion in additional Medicare Advantage payments from differential coding.

“CMS’s agreement, at our request, to assign separate codes to SINUVA and PROPEL reflects and supports our deliberate strategy to leverage Intersect ENT’s proprietary drug eluting sinus stent ...