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7 Achievable New Year’s Resolutions For Healthier Coding & Reimbursement in 2018

25. January 2018

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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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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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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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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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Ups and Downs, MACRA Modifiers, and E/M DGs in MPFS 2018 Proposed Rule

25. July 2017

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Part 3 of our proposed rule extravaganza is about the Medicare Physician Fee Schedule (MPFS) 2018 proposed rule. (Part 1 was QPP and Part 2 was OPPS). Let’s get down to business, checking out some highlights explained in recent issues of Medicare Compliance and Reimbursement. Plusses and Minuses The proposed 2018 conversion factor is 35.99, […]

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4 Things to Watch From the OPPS 2018 Proposed Rule

21. July 2017

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We’re back for another installment of “what does 2018 (maybe) have in store”? We just covered the QPP proposed rule, and now we’ll take a look at the 2018 hospital outpatient prospective payment system (OPPS) proposed rule. CMS expects an overall 2 percent payment increase in 2018 (except for the changes mentioned in question 3 […]

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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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Don’t Get Too Comfortable With That Meaningful Use Payment – Here’s Why

20. June 2017

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When the title of an OIG report is about Medicare paying out hundreds of millions it shouldn’t have, that’s not great news for Medicare or the providers who got those funds. But that’s exactly what a report released June 12, 2017, says: “Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did […]

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