- 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.
- 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?
- Ensuring clear and concise documentation critical for case managers
Proper documentation is critical when it comes to supporting medical necessity and providing quality patient care. Case managers can be a crucial component when it comes ensuring documentation supports medical necessity.
- WEDI survey reveals ICD-10 uncertainty
In a letter to HHS, the Workgroup for Electronic Data Interchange summarized the findings of its February 2015 ICD-10 readiness survey, which revealed uncertainty among providers, vendors, and health plans.