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If you treat Medicare Advantage patients, you must also know your HCCs (hierarchical condition categories) and your ICDs (International Classification of Diseases).
Since 1992, Medicare has paid for the services of physicians, non-physician practitioners, and certain other providers under the Medicare Physician Fee Schedule (PFS).
Occasions arise when treating a patient where an evaluation and management service and a surgical or infusion service or another procedure occur on the same date.
Currently, nearly 2.3 million U.S. inmates (about 1 percent of U.S. adults) must rely on their jailers for healthcare. However, there is little nationally available data on the health and healthcare of America’s prisoners.
It is an act of Congress, specifically section 218 of the Protecting Access to Medicare Act (PAMA) of 2014, which requires all physicians ordering advanced imaging studies to consult government-approved, evidence-based appropriate use criteria through a clinical decision support system.
action 60 accc-cancer.org | July–August 2017 | OI A comprehensive look at oncology reimbursement issues, tools to strengthen your program, and information to help you weather market changes. All members of the cancer care team who deal with oncology business and reimbursement will benefit from these meetings. Gain a full-spectrum perspective in just one day of sessions: • Hear …
As reimbursement continues to shrink through bundling, packaging, service consolidation, and other changes to insurance payment systems, many providers are training staff to collect coinsurance, deductibles, co-payments, and other patient cost-shares at the time of service.
MA17-Soreness-Discomfort-Aches-&-Pains
The 2017 final regulations, code updates, and other reimbursement changes once again bring challenges to oncology coding and billing.
In CY 2017, outpatient hospital payment rates will increase by 1.7 percent and CMS will continue the statutory 2.0 percentage point reduction in payments for hospitals that fail to meet the hospital Outpatient Quality Reporting Program requirements.
The CY 2017 conversion factor is estimated to be $35.8887, which is slightly higher than the 2016 conversion factor of $35.8043.
Effective Oct. 1, 2016, the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) will add or update approximately 1,943 diagnosis codes in the ICD-10-CM coding classification.
Advance directives only work if the individual understands the document, his or her surrogate understands the individual’s wishes, the physician is aware of the document’s existence, the physician complies with the surrogate’s instructions, and the document is revised as an individual’s condition and goals change.
In order to be reimbursed for telehealth services, specific criteria must be met and unique procedure codes and modifiers must be appended to identify the services performed.
Again this year oncology practices and cancer programs scramble to update their respective chargemasters, fee schedules, and other reimbursement documents to ensure compliance with coding and billing guidelines.
Since 1992, Medicare has paid for the services of physicians, non-physician practitioners, and certain other suppliers under the Medicare Physician Fee Schedule (MPFS).
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