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Did You Catch It? New Year, New Look for CLFS

17. January 2018

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Your 2018 preparations for lab coding aren’t complete if you haven’t looked into the changes to the Clinical Laboratory Fee Schedule (CLFS). Here are some hints from Pathology/Lab Coder to point you in the right direction. Get an Overview of the CLFS Makeover The 2018 CLFS brought a major overhaul to payment for lab testing. […]

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Survey Says: 83 Percent of Physicians Report Cybersecurity Attacks

8. January 2018

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Four out of five U.S. physicians surveyed reported experiencing a cyberattack, according to research from the AMA and Accenture. The role of electronic health information is growing, and the information itself is attractive to criminals interested in gaining private information. All of that makes cybersecurity a crucial issue for the healthcare industry and every patient, […]

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Improve Your Knowledge of the MIPS Improvement Activities Category

3. January 2018

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There’s no time like New Year’s to think about improvement! Improvement activities in MIPS, that is. Background: MIPS focuses on the categories of quality, cost, practice-based improvement activities (IA), and advancing care information (ACI), the last of which focuses on use of certified electronic health record technology (CEHRT). It can be tough to wrap your […]

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We’ve Wrapped Up 4 Medicare PET Coding and Coverage Resources for You!

21. December 2017

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CMS keeps a close eye on PET imaging, and that means you need to, too. Make sure you’re using all of these resources so you understand coding and coverage for this high-tech imaging option. 1. Know Where to Find NCD Details Medicare has a National Coverage Determination (NCD) for PET scans, with specifics for everything […]

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Yea or Nay? See Which QPP 2018 Proposals Came Through in the Final Rule

14. December 2017

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Back in July, TCI SuperCoder blog had a post about the proposed 2018 Quality Payment Program (QPP) rule, a program established under MACRA. Now that the final rule (with comment period) is out, let’s see how some of those proposals fared. Small Provider Exemption/Low-Volume Threshold Proposal: The proposed rule included adjusting the 2017 low-volume threshold […]

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What Does ICD-10 Have to Do With Prescriptions to Treat Acute Pain?

27. September 2017

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We’re just days away from ICD-10 2018 implementation. One group with ICD-10-CM on the brain may be Ohio pharmacists. Here’s why: Effective Dec. 29, 2017, there will be new rules in Ohio for prescribing opioids. One of the requirements is for the prescription to include “The ICD-10-CM medical diagnosis code of the primary disease or […]

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Straight From the Source: Use Modifier 25 the Right Way With CCI Manual Tips

22. September 2017

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It can be tricky knowing when to append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service). More specifically it can be tough to determine whether work performed by a provider amounts to a separate […]

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Are These ASCQR Resources on Your List?

5. September 2017

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The Ambulatory Surgical Center Quality Reporting (ASCQR) Program affects Medicare reimbursement for ASCs. In short, ASCs have to meet administrative, data collection, and data submission requirements to avoid a payment reduction. Here’s a look at some ASCQR resources recently listed in Outpatient Facility Coding Alert. 1. CMS ASCQR Page The CMS ASCQR page links to […]

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Pair These ICD-10 2018 Official Guideline Updates With Their Code Set Counterparts

18. August 2017

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The ICD-10-CM 2018 Official Guidelines are out and ready for review. When you check through the new OGs for changes, take special note of these updates that line up with 2018 code set revisions. Look at Level to Choose ‘In Remission’ Code When you start to apply new codes for substance abuse in remission (you’ll […]

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Transition and Flexibility Are the Buzzwords for QPP 2018 Proposed Rule

18. July 2017

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CMS released the proposed 2018 Quality Payment Program (QPP) rule on June 20. To sum up the 1,000+ pages, 2018 will be something of a transition year like 2017 was for QPP, which was established under MACRA. If you read through the various summaries available, you’ll see the term “flexibility” used quite often, with specialty […]

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