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APCs Insider HIM-HIPAA Insider Medicare Insider

APCs Insider

This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations. Topics include the outpatient code editor (OCE), complex coding issues, beneficiary co-payment discounting, and cross-department APCs tracking.

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Issue 3, January 22, 2016

• Providers see only minor productivity declines after ICD-10 implementation, according to survey

  A decrease in staff productivity has been the top challenge for providers after ICD-10 was...

• Q&A: Submitting claims for observation services

  Q: Did something change with the observation services Composite APC in 2016? The director of...

• Tip: CMS restructures APCs for nine clinical families

  CMS followed through with its proposal to restructure APCs for nine clinical families in the 2016...

• Pay-per-view: CMS shifts 2-midnight rule responsibility to QIOs, finalizes packaging expansion

  CMS finalized its proposals regarding the 2-midnight rule, including moving responsibility for rule...

• Trivia

  A Swiss German deck of playing cards uses which suit instead of clubs? 

Issue 2, January 15, 2016

• Does your facility continue to struggle with injections and infusions coding?

  Despite few recent code or rule changes in recent years, coders and HIM managers I hear from...

• Q&A: Should we hardcode modifier -CT?

  Q: Our radiology department is requesting that we add a new modifier to their charge description...

• Tip: CMS adds payment for advance care planning in certain scenarios

  CMS changed the status indicator for CPT code 99497 (advance care planning including the...

• Pay-per-view: CMS backs off some burdensome proposals but imposes negative payment update in latest rule

  The 2016 OPPS final rule includes the first negative payment update for the system, but CMS also...

• Trivia

  Which of the following modern Olympic events lasted for the longest period of time?

Issue 1, January 8, 2016

• NCCI Manual includes clarifications for modifier -59 usage, injections and infusions

  With the latest edition of the NCCI Manual, effective January 1, CMS does not introduce any new...

• Q&A: Setting a price for corneal tissue

  Q: I have a follow-up question to an answer you gave early last year. The question was about...

• Tip: CMS issues first OPPS negative payment update

  CMS finalized its proposal to reduce the conversion factor by 2% to account for its overestimation...

• Pay-per-view: Accuracy is paramount for providers when reporting CMS’ new modifiers for 2016

  Providers often struggle with modifiers—even those they've had available to report for many...

• Trivia

  Which food was declared the official state vegetable of Oklahoma in 2007?