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Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules and how they impact hospital health information management systems and processes, coding, billing, and reimbursement.

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Issue 12, December 1, 2013 - VIEW THE FULL ISSUE

• Clearing the confusion with injections and infusions

  Healthcare providers are used to regularly changing guidelines and regulations that drastically...

• Applying drug administration coding concepts

  During the January injections and infusions audio conference, Jugna Shah, MPH, president and...

• ICD-10 anatomy refresher: Knee

  Editor's note: With the increased specificity required for ICD-10-CM coding, coders need a solid...

• This month's coding Q&A

  Q. Can a medically unlikely edit (MUE) and National Correct Coding Initiative (NCCI) edit be...

Issue 11, November 1, 2013 - VIEW THE FULL ISSUE

• Build a foundation for ­ICD-10-CM coding

  ICD-10-CM implementation is less than a year away and coders should be starting their ICD-10-CM...

• ICD-10 neoplasm codes: New look, similar steps

  With some major changes in look and form-but generally adhering to existing guidelines-coding for...

• Identify elements for appropriate E/M level

  Coders select E/M levels based on criteria developed by their organization. CMS has proposed a...

• This month's coding Q&A

  Our experts answer questions about followup visits in the ED, skin substitutes, flu vaccines...

Issue 10, October 1, 2013 - VIEW THE FULL ISSUE

• Wrap your arms around data analytics before ICD-10

  ICD codes are the ultimate source of information for the healthcare ­industry. Coders in every...

• Experts weigh in on proper use of modifier -59

  Despite its apparently straightforward definition in the CPT® Manual, modifier -59 (distinct...

• CMS adds modifier, new HCPCS codes

  CMS added modifier -AO (provider declined alt payment method) and new HCPCS codes to the I/OCE as...

• This month's coding Q&A

  Our experts answer questions about NCCI edits for injections, modifier -25, modifier -59...

Issue 9, September 1, 2013 - VIEW THE FULL ISSUE

• CMS proposes additional packaging plans for 2014

  Get ready for more packaged services, including laboratory tests and add-on codes, if CMS finalizes...

• Significant changes proposed for E/M coding

  E/M coding and reimbursement for hospital outpatients could change dramatically if CMS finalizes...

• Additional proposed changes to OPPS for 2014

  The 2014 OPPS proposed rule is shorter than normal at 718 pages, but the proposed changes are...

• Comment on the 2014 OPPS proposed rule

  CMS wants your thoughts on the 2014 OPPS proposed rule changes. In various places in the proposed...

• This month's coding Q&A

  Our experts answer questions about billing vasectomy and sperm analysis, coding for ED visit when...

Issue 8, August 1, 2013 - VIEW THE FULL ISSUE

• GEMs a useful addition to ­ICD-10-CM transition toolkit

  General equivalence mapping (GEM) is a good tool to use to convert ICD-9-CM codes to ICD-10-CM, but...

• Correctly report G codes for physical therapy

  In January 2013, CMS introduced 42 therapy functional reporting G codes (nonpayable). These...

• CMS changes code status, adds APCs, modifier

  Eight CPT® codes for multianalyte assays with algorithmic analyses (MAAA) procedures are now...

• History shows importance of proper cost reporting

  Providers setting charges based on an understanding of their costs is not a new concept, says Jugna...

• This month's coding Q&A

  Our experts answer questions about injections and infusions, rubber stamp signatures, and...

Issue 7, July 1, 2013 - VIEW THE FULL ISSUE

• CMS seeks ­provider comments on molecular pathology rates

  The AMA revamped coding for molecular pathology beginning in 2012 and continuing in the 2013...

• CMS proposes change to inpatient criteria

  CMS is reexamining inpatient criteria because it has seen a significant increase in the number of...

• ICD-10-CM training a two-way street

  Coders will see plenty of changes when they start using ICD-10-CM codes. Many codes require more...

• This month's coding Q&A

  Our experts answer questions about injections and infusions, edits for flushing a line, and...

Issue 6, June 1, 2013 - VIEW THE FULL ISSUE

• Check out the view from the industry as ICD-10 implementation draws closer

  ICD-10 implementation challenges will vary from organization to organization, depending on size...

• Shrink radiation oncology coding confusion

  Radiation oncology uses high-energy radiation to shrink or kill tumors or cancer cells with minimal...

• CMS releases details on Part A to B rebilling

  Providers were glad to see CMS' ruling (CMS-1455-R) released March 13 (published in the Federal...

• This month's coding Q&A

  Our experts answer questions about hydration, excludes notes in ICD-10-CM, L codes for...

Issue 5, May 1, 2013 - VIEW THE FULL ISSUE

• CMS changes Part B inpatient billing in hospitals

  Successful appeals can actually lead to CMS policy changes. Facilities have been successfully...

• Molecular pathology reimbursement still unclear

  The AMA revised the molecular pathology codes in the CPT® Manual in 2012, but at that time...

• CMS corrects edit 84, deletes modifiers

  CMS corrected edit 84, added five APCs to the I/OCE, deleted two APCs, and changed the description...

• This month's coding Q&A

  Our experts answer questions about modifiers for diagnostic interventional procedures, Medicare...

Issue 4, April 1, 2013 - VIEW THE FULL ISSUE

• CMS changing MUEs

  CMS is making a significant change to the Medically Unlikely Edits (MUE) by changing some of them...

• New molecular pathology coding still complex

  Editor's note: Facilities need to address coding, payment, and coverage issues for molecular...

• Audits help lock down processes, clarify coding

  Being audited is rarely fun. After all, you're probably going to lose money, face a fine, or both...

• This Month's Coding Q&A

  Our experts answer questions about, modifier -25, cardioversion performed during an ED code...

Issue 3, March 1, 2013 - VIEW THE FULL ISSUE

• Follow the right path for coding nonvascular interventional radiology

  When coders hear the words "interventional radiology," many think of vascular procedures...

• AMA revises, deletes radiology codes for 2013

  The AMA added five new nuclear medicine codes to the radiology section of the 2013 CPT Manual...

• CMS adds significant number of new codes

  CMS added 410 new codes and seven new therapy and patient condition modifiers to the I/OCE as part...

• This Month's Coding Q&A

  Our coding experts answer your questions about physician supervision for chemotherapy, billing...

Issue 2, February 1, 2013 - VIEW THE FULL ISSUE

• Note major changes in ­medicine section

  After 14 years of few to no changes, the psychiatry section of the CPT® Manual received a major...

• New codes for cardiology procedures added to manual

  In November 2011, the FDA approved ­transcatheter aortic valve replacement (TAVR) to treat...

• AMA introduces neutrality for provider types

  One of the major changes to the 2013 CPT Manual is the replacement of the term...

• Ensure correct reporting of place of service code

  Physicians and other providers practice in many ­different areas within a hospital. To...

• This Month's Coding Q&A

  Our coding experts answer your questions about reporting MRI, MRA together, reporting negative...

Issue 1, January 1, 2013 - VIEW THE FULL ISSUE

• CMS finalizes changes to drug payments, relative weight calculations

  Hospitals earned a big win with drug payments this year in the 2013 OPPS final rule, released...

• CMS packaging clarification could raise problems

  As part of the 2013 OPPS final rule, CMS finalized a clarification to 42 CFR 419.2(b) that could...

• Hospitals see therapy, molecular pathology changes

  The biggest operational change for outpatient facilities for 2013 does not appear in the 2013 OPPS...

• Begin teaching providers to speak ICD-10

  Providers and coders seem to speak two different languages-clinical and coding. Providers already...

• This Month's Coding Q&A

  Our coding experts answer your questions about reporting fetal ultrasound codes, bell curve for E/M...

• Briefings on APCs 2012 index

  Track down that hard-to-find Briefings on APCs article. Use our index to find articles we published...