- Senate passes SGR bill, ICD-10 implementation date stands
Late in the evening Tuesday, April 14, Congress passed the Medicare and Children's Health Insurance Program (CHIP) Reauthorization Act (MACRA), effectively ending the 17-year battle over cuts to physician reimbursement associated with the Sustainable Growth Rate (SGR).The new law puts in place a merit-based incentive payment system (MIPS) that awards bonuses or imposes penalties based on physicians’ composite performance scores.
- Experts take on ED case management questions
The emergency department (ED) case manager has a number of critical functions in any hospital. During HCPro’s February webcast “Emergency Department Case Management: Manage Challenging Patients and Special Populations,” speakers talked about the challenges ED case managers face and the important role that they play.
- CMS focuses on quality measures in FY 2016 IPPS proposed rule
CMS released its fiscal year 2016 IPPS proposed rule April 17, announcing potential changes to MS-DRGs, the market basket update, and value-based payment quality measures.
- Q&A: Rejections for codes without internal edits
Q: We are receiving rejections for HCPCS codes J0365 (injection, aprotonin, 10,000 kiu) and J7180 (injection, factor xiii [antihemophilic factor, human], 1 i.u) when we report them on a claim. We are not receiving any internal edits for this.
- Poll: Health problems are caused by more than just germs
American’s don’t think health is only about what happens to their bodies. They think it’s a result of outside experiences, according to a new poll by National Public Radio, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health.
- Q&A: We now receive edits on certain skin substitutes
Q: We have been reporting skin substitutes with the appropriate procedure codes (either CPT® or HCPCS C codes) with no problems. However, we are now receiving an edit that tells us we have a mismatch between the procedure code and the Q code for skin substitute such as Allowrap® and Dermavest™. What changed?