Home

  • Home
    • » Search Results

Search Results

« First « Previous    Next »
Displaying records 1 to 20 out of 5645 results for "observation no part B coverage".
( Page 1 of 283 )
SORT RESULTS BY: RELEVANCY | PUBLICATION DATE
Medicare Boot Camp®—b>Utilization Review Version
Stakeholders take NOTICE of mounting ­observation status reform legislation b
Medicare Boot Camp®—b>Utilization Review Version
Medicare Boot Camp®—b>Utilization Review Version b> >
Due to popular demand, we’ve added another Medicare Boot Campb>®
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Due to popular demand, we’ve added another Medicare Boot Camp®—Utiliz
Medicare Boot Camp—b>>Utilization Review Versionb>> is an i
Medicare Boot Camp®—b>Utilization Review Version
The number of patients requiring observation services will likely increase for many hospitals as
Connolly posts two new issues in two categoriesb> Connolly posted two new
Medicare mythsb> Editor's note: This article is excerpted f
AUGUST 1, 2015
ICD-10-related updates made to the Medicare Claims Processing Manualb>
OIG acting deputy inspector general testifies about Medicare mismanagementb>
CMS updates billing instructions for TMVRb>  On April 24, CMS rescin
CMS issues change request for lumbar decompression coverage> On May 16,
It’s a question that physicians struggle over daily: Inpatient or observation?  
DECEMBER 16, 2014
Q:> CMS released guidance this summer about not auditing or counting errors for the specifi
Update to Medicare Claims Processing Manualto provide language-only changes for updatin
President's FY 2016 Budget Includes Medicare Provisionsb> On F
 The Joint Commission announced an update of its “observer” definition in its a
FEBRUARY 14, 2017
Update to Medicare Claims Processing Manual, Chapters 12, 20, 32, and 35 to prov
Transcatheter Mitral Valve Repair (TMVR) NCDb>   On Apri
CMS updates billing instructions for TMVR b>On April 24, CMS rescinded and replaced Trans
July update to the calendar year (CY) 2014 Medicare Physician Fee Schedule Databaseb>
Update to surety bond collection proceduresb> On May 16, CMS released a change request
HHS solicits of new safe harbors and special fraud alertsb>  On Dece
Statistical sampling initiative for claims beginsb> The Office of Medicar
Statistical sampling initiativeb> The Office of Medicare Hearings and Appeals (OMHA) w
Update to surety bond collection proceduresb> b> >
Since 1997, venipuncture has not been a qualifying service for Medicare coverage. However, once
Correction notice to IPPS final ruleb> On March 18, CMS and HHS issued a
CMS identifies obsolete shared systems reportsb> On May 1, CMS released a
Solicitation of new safe harbors and special fraud alertsb>  
Solicitation of new safe harbors and special fraud alertsb> On December 30, HHS posted
Q>:    If a resident used 100 days with the peg tube at another facil
OCTOBER 9, 2014
The coverage of nonroutine supplies is probably the most confusing component of the consolidated
  Part B Outpatient Therapy Q&A
  Part B Therapy Billing: Functional reporting and G-codes webcast
OCTOBER 13, 2017
  CMS releases 2019 Medicare Parts A&B premiums and deductibles
OCTOBER 19, 2018
  Frequently asked questions about Medicare Part B
NOVEMBER 30, 2018
HOP Panel summer meeting scheduledb> CMS announced the summer meeting of
BALTC Q&Ab> Editor's note: This month's "Q&A&q
CMS allows contractors to use alternate medical documentation to ID illegible signaturesb>
CMS revises travel allowance fees for collection of specimensb>  On
CMS releases October 2014 OPPS updateb>  On August 1, CMS relea
Statistical sampling initiativeb> The Office of Medicare Hearings and App
CMS updates interest rate for Medicare overpayments and underpaymentb> 
CMS posts July update to Medicare Physician Fee Schedule Databaseb> On June 6, CMS rel
CMS revises signature requirementsb> On July 24, CMS released a change re
Identification of Obsolete Shared System Maintainer (SSM) reports - FISS and VMSb>
CMS identifies obsolete shared systems reportsb> On May 1, CMS released a change reque
CMS posts final decision on HIV screening b>  On April 13, CMS poste
OIG releases report on drugs commonly used by dual-eligible beneficiariesb>
HCPCS codes subject to and excluded from CLIA editsb>  On January 30
National Coverage Analysis (NCA) for screening for the Human Immunodeficiency Virus (HI
Implement operating rules - Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment
2015 annual update of HCPCS codes for SNF consolidated billing (CB) updateb>
Medicare Advantage Q&A with Diane Brownb> b>QWe have chro
FEBRUARY 1, 2015
2015 annual update of HCPCS codes for SNF consolidated billing (CB) updateb>
CMS revises coverage of cardiac rehabilitation programsb> On August 29, C
Residency Program Insider b>won’t be publis
NOVEMBER 22, 2013
CMS needs to evaluate, clarify, and modify sections of the Notice of Observation Treatment and Im
CMS posts final decision on HIV screening  b> On April 13, CMS posted a final dec
CMS releases April 2015 I/OCE specifications b> On March 13, CMS released
Influenza vaccine payment allowance updateb> On September 3, CM
Notice of new interest rate for Medicare overpayments and underpaymentb>
Notice of new interest rate for Medicare overpayments and underpaymentb>
Q: >Our reimbursement department says that we are no longer being paid for APCs 8002 a
FAQs–ICD-10 acknowledgement testing and end-to-end testingb> On January 5, CMS r
CMS releases National Coverage Determination for single and dual chamber permanent card
April 2015 Integrated OCE (I/OCE) specifications version 16.1b>  
The Advisory Panel on Hospital Outpatient Payment (HOP Panel) summer meeting b>
Taking the mystery out of consolidated billingb> In the Balanc
DECEMBER 1, 2014
CMS updates influenza vaccine payment allowanceb>  On September 3, C
Q&A: Long-term care ICD-10 coding specificsb> Editor's
JANUARY 1, 2015
Revisions to State Operations Manual (SOM), Appendix PP –“Gui
CMS releases 2015 annual update for HPSA bonus paymentsb>  On Octobe
  GAO: New payment rates for Part B lab tests may lead to billions in overpayments
DECEMBER 14, 2018
CMS makes policy and payment changes to the Medicare Physician Fee Schedule for 2015b
CMS releases ICD-10 acknowledgement and end-to-end testingb> details>
Correction to remittance messages when hospice claims are reduced due to late filing of
CMS releases April 2015 I/OCE specifications b>On March 13, CMS released a notification to p
Cardiac rehabilitation programs for chronic heart failureb> On August 29, CMS rescinde
Bilateral procedures may have been incorrectly paidb> On June 30, CMS released MLN
Accreditation & Quality Advisorb> blog! The
MARCH 31, 2015
CMS provides front-end updates for Julyb> On March 26, CMS released a cha
CMS solidifies a fix to the COT OMRA policy in 2015 final ruleb>
NOVEMBER 1, 2014
CMS revises travel allowance fees for collection of specimens b> On January 23, CMS re
Clinical laboratory fee schedule–Medicare travel allowance fees for collection of
CMS pushed back the deadline for physicians to enroll to prescribe Medicare Part D drugs. Physici
FAQs–ICD-10 acknowledgement testing and end-to-end testingb>  
Long-Term Care Billing Webcast b>is a 90-minute webcast where expert 
APRIL 25, 2014
National Coverage Determination (NCD) for Single Chamber and Dual Chamber Permanent Car
Provider Reimbursement Manual update b> On May 23, CMS released
CMS announces final regulatory changes affecting Medicare Parts C and Db>
AUGUST 1, 2014
Medicine from afarb> How one critical access hospital turned to telemedicine to be
NOVEMBER 1, 2013
CMS issues National Coverage Determination (NCD) for single chamber and dual chamber permanent
CMS updates information for billing screening servicesb> On April 3, CMS
Continuation of systematic validation of payment group codes for PPS based on patient assessme
Continuation of systematic validation of payment group codes for PPS based on patient a
DECEMBER 23, 2014
JUSTCODING
Editor's note: Parts of this article have been adapted from the popular HCPro title,
APRIL 21, 2017
CMS outlined how to access updates to ICD-10 Local Coverage Determinations (LCDs) in its M
JUNE 25, 2014
JUSTCODING
Observation and Reporting. Please click on the PDF icon. Observation and Reporting
Correction to remittance messages when hospice claims are reduced due to late filing of
On February 1, 2018, CMS proposed new Medicare Advantage and Part D payment and policy updates to
CMS releases the Medicare fee-for-service 2013 improper payments reportb>
FEBRUARY 1, 2015
Q&A: Finance and budgetingb> Editor's note: This month'
AUGUST 1, 2014
Durable medical equipment in the SNF: It's more than just walkers and wheelchairs
DECEMBER 1, 2014
NPDB Guidebook changes could mean shifts in reportable actions b>
Notice of new interest rate for Medicare overpayments and underpayments-Third quarter n
Third quarter 2015 notice of new interest rate for Medicare overpayments and underpayments pos
Q: >If a patient is discharged to a behavior management unit that is hospital-b
On November 24, the OIG posted a report stating that Medicare Part B and its beneficiaries paid $
DECEMBER 15, 2015
AHA posts letter on 2-midnight policy and potential short-stay payment solutionsb>&nb
Implementation of NACHA operating rules for healthcare electronic funds transfers b>
Q: > When a Part A resident exhaust their Part A days and needs continued thera
October CY 2015 quarterly update to the Medicare physician fee schedule datab
Revisions to State Operations Manual (SOM), Appendix PP –“Gui
By Glenn Krauss,BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDIb> Excisional debr
JANUARY 14, 2015
JUSTCODING
Q: b>An observationpatient received an IV push on the first day (9/28) and an infusion the n
CMS releases October 2015 quarterly update of HCPCS drug/biological code changesb>
Does your FPPE process address the growing numbers of AHPs applying to your facility?b>
NOVEMBER 1, 2013
Medically Unlikely Edits (MUE) and Bilateral Proceduresb> b> >
CMS releases directions on the off-label/modified use of waived blood glucose monitorin
CMS and AMA announce efforts to ease transition to ICD-10 for providersb>
October 2014 update of the hospital outpatient prospective payment System (OPPS)b> On
Cardiac rehabilitation programs for chronic heart failureb>  
Helping hand-offs b> b>&l
FEBRUARY 1, 2014
Q: We're not sure what to report in this situation: A patient comes to the ED and goes
SEPTEMBER 3, 2014
JUSTCODING
Updates of MS-DRGs to the list subject to IPPS replaced devices offered without cost or
One on One Educationb>   On October 31, CMS released a c
CMS has contracted with an SMRC to lower improper payment rates b>
SEPTEMBER 1, 2014
Termination of the Common Working File ELGA, ELGH, HIQA, HIQH, and HUQA Part A Provider Querie
To clarify and correct existing instructionsb> On September 19, CMS relea
CMS clarifies treatment of extracorporeal photopheresisb>  On August
Health Professional Shortage Area (HPSA) Post-payment Review Processb>
HIPAA EDI front end updates for July 2015b>   On March 2
Trustees’ report shows Medicare solvent to 2030b> b> >
The AMA House of Delegates last week approved a set of principles to ensure appropriate coverage
The AMA House of Delegates last week approved a set of principles to ensure appropriate coverage
Q: We have been providing lung cancer screening using a low-dose computed tomography (LDCT)
Termination of the Common Working File ELGA, ELGH, HIQA, HIQH, and HUQ
October 2014 update of the hospital outpatient prospective payment System (OPPS)b>
CMS clarifies coverage of extracorporeal photopheresisb>  On August
Modifying the Daily Common Working File (CWF) to Medicare Beneficiary Database (MBD) Fi
  Dental, hearing, and vision services to be added under Medicare coverage?
JANUARY 19, 2017
Intensive behavioral therapy for obesity, screening digital tomosynthesis mammography,
Standardization isn't 'just an exercise in change
NOVEMBER 1, 2014
We are assessing and observing if we have an issue related to medical error. Tie it to the advers
Revisions to State Operations Manual (SOM), Appendix A&ndash
Extracorporeal photopheresisb>   On August 22, CMS relea
CMS releases January 2015 update of the ASC payment systemb>  On Jan
Transitions of care: What’s your policy? b>
FEBRUARY 1, 2014
Sally Pelletier, CPMSM, CPCSb>, answers a co
Common consolidated billing issues facing SNFsb> Consolidated
Q: >The resident is on their Part A benefit and is scheduled for dialysis 3 day
CMS releases ICD-10 conversion update for NCDsb> On March 6, CMS released
To clarify and correct existing instructionsb>   On Sept
SEPTEMBER 30, 2014
The Medicare appeals process has become a logjamb> The Medicar
AUGUST 1, 2014
The Centers for Medicare & Medicaid Services (CMS) has announced the 2014 Part B premiu
NOVEMBER 22, 2013
Privileging physician assistants in urologyb> Editor's note
2015 annual update to the therapy code list releasedb> On November 14, CMS released a
Editor’s Note: b>James S. Kennedy, MD, CCS, CDIP,director of CDIMD Physician
CMS posts guidelines for clinical laboratories concerning possible Ebola virusb> 
Make sure your staff knows and implements your policy on continuous observation of suicidal pati
FEBRUARY 1, 2019
Health Professional Shortage Area post-payment review processb> On March
Q: An auditor recently reviewed our outpatient ED claims and told us that we canno
Q: Does a spell of wellness end with observation time in a hospital?
OCTOBER 17, 2014
CMS provides front-end updates for Julyb> On March 26, CMS released a change request t
Include diagnosis codes on the HIPAA Eligibility Transaction System (HETS) 270/271 Tran
Medicare Trustees Report shows continued slow cost growthb> On July 22, C
By now, I’m sure you all have had just about your fill of news coverage about Ebola. And th
NOVEMBER 5, 2014
CMS updates information for billing screening services b> On April 3, CMS released a c
AHA posts letter on 2-midnight policy and potential short-stay payment solutions b>On Februa
By James S. Kennedy, MD, CCS, CDIPb> The physician documented “encephalopathy&
MARCH 25, 2015
JUSTCODING
The aging physician: Some practical tips b> by William K. Cors
SEPTEMBER 1, 2014
Clarifications made to the Medicare Benefit Policy Manual and Medicare Progra
Modifying the Daily Common Working File (CWF) to Medicare Beneficiary Database (MBD) Fi
How stable is the Medicare Advantage program?b> On July 24, th
OCTOBER 1, 2014
Medicare Boot Camp—Hospital Version b>prepares you to better manage your revenu
CMS bumps up SNF payment rate increase in FY 2015 proposal b>
AUGUST 1, 2014
Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC) and Remittance
January 2015 update of the ASC payment systemb> On January 9, CMS released a recurring
CMS releases fourth version of related claims transmittalb> On September
Third quarter 2015 notice of new interest rate for Medicare overpayments and underpayme
The first Memorial Day observance was held May 30, 1868, at Arlington National Cemetery. B
Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for solid tumors (This chan
CMS replaces transmittal for Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for s
  Bill introduced to add dental, hearing, and vision services under Medicare coverage
FEBRUARY 1, 2017
Q:> A patient came to the emergency department with shortness of breath (SOB). The admittin
Red hot PEPPERs: Why SNFs should access their 2015 reports next monthb>
Revisions to State Operations Manual (SOM), Appendix A–Survey proto
Directions on the off-label/modified use of waived blood glucose monitoring systems (BG
Provider-Based Entities: A Guide to Regulatory and Billing Complianceb> is a comprehensive
Clarification to Medicare Benefit Policy Manual regarding antigens and deletion of Sect
APRIL 2, 2014
JUSTCODING
Conference confidence b> b>
FEBRUARY 1, 2014
CMS updates contractor instructions for enrollment and re-enrollment applications b>
Editor’s Note:b> >The following job posting is an excerpt from the&n
William K. Cors, MD, MMM, FACPEb>, chief medical quality officer at Pocono Heal
DECEMBER 1, 2014
CMS releases July 2014 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files
January 2015 update of the ASC payment systemb>   On Jan
CMS releases coverage criteria for TAVR volume requirementsb> 
CMS rescinds and replaces Transmittal 166 for technical correctionb> On M
SEPTEMBER 30, 2015
JUSTCODING
Written by Jennifer Thew, RN Originally appeared in HealthLeaders Media b
NOVEMBER 9, 2017
CMS updates contractor instructions for enrollment and re-enrollment applications b>
A patient under observation at Massachusetts General Hospital in Boston for a suspected case of E
DECEMBER 4, 2014
CMS releases July update to Medicare Physician Fee Schedule databaseb> 
Clarification to Pub. 100-02, Medicare Benefit Policy Manual Regarding Antigens
Claims that are relatedb>   On September 12, CMS release
SEPTEMBER 23, 2014
It’s hard to believe that it’s been almost a year since parts of the Midwest s
MAY 28, 2014
Q: I am auditing a note for a b>>fusion. The note lacks detail, therefore
MARCH 5, 2014
JUSTCODING
Q: > Should a blood tranfusion received at an outpatient clinic be coded on the
Q: >If a patient uses part of a 100 day benefit for a G-Tube can we ever skill
AUGUST 1, 2014
“If some parts of the hospitals are 24 hour, why not all? Why can’t the hospit
APRIL 16, 2015
Quarterly ASP Medicare Part B drug pricing files released b> On April 25,
Claims that are relatedb> On September 12, CMS released a fourth version
CMS updates contractor instructions for enrollment and re-enrollment applications  
HCPro announced key findings today that are part of a nation-wide survey of hospitals about the
OCTOBER 9, 2009
Health Professional Shortage Area (HPSA) Post-payment Review Processb> On March 25, CM
In 10% of cases, patients placed on observation status pay more for their care than they would ha
CMS extends coverage of aprepitant for chemotherapy-induced emesis b>
Q:> If the physician says “concerning for,” “considering,” &ld
Star razing: Providers face quality rating dips after system recalibration b>
We continue our coverage of HCPro’s latest survey of residency coordinators this month with
OCTOBER 9, 2019
One of the most interesting parts of my job is helping folks through the actual Joint Commission
SEPTEMBER 24, 2015
CMS 2015 SNF PPS final rule to increase payments to skilled nursing facilitiesb>
OCTOBER 1, 2014
Does your organization have a utilization management ­committee?b> Did y
NOVEMBER 1, 2013
Bring your entire team as we explore part three of our three-part patient status summer we
Direct observations are an important component of competency-based medical education for resident
APRIL 1, 2020
  Our continuing coverage of the survey wars brings us to the June 4 edition of Jo
JUNE 19, 2014
There has been a fair amount of coverage on the documentation requirements needed to assign ICD-1
New pass-through items in 2016b> b>Q: Is CMS adding any items with pass-thr
Q: A patient came to the ED with shortness of breath (SOB). The admitting diagnosis was possib
APRIL 22, 2015
JUSTCODING
Q: Our ophthalmologists have begun using injections of antibiotics during cataract surg
Editor’s Note:b> The following job posting is an excerpt from the
Observation status is not working as a way of classifying hospital patients and should be
NOVEMBER 14, 2014
Q: Which root operation would we use in ICD-10-PCS for a polypectomy when a biopsy is done on
APRIL 8, 2015
JUSTCODING
Aprepitant for Chemotherapy-Induced Emesisb> b> 
SNF Consolidated Billing: Who Really Has to Pay All These Invoices?
SNF Consolidated Billing: Who Really Has to Pay All These Invoices?
AUGUST 1, 2014
Q: Our physicians are injecting a lot of bulking substances, such as those for strength
Risk adjustment is central to pay for performance, whereby high-quality cost effective care can b
OCTOBER 28, 2015
JUSTCODING
Physician Quality Reporting System 2013 reporting year and 2015 payment adjustment for
October is National Breast Cancer Awareness Month. An important part of this campaign is g
OCTOBER 29, 2014
JUSTCODING
CMS recently released its seventh maintenance update for National Coverage Determinations (NCD)
The use of “Observation Status” – treating certain hospitalized Medicare patien
AUGUST 21, 2014
Do you have a Medicare patient who has been on observation status in your hospital for more than
SEPTEMBER 1, 2015
Reporting laboratory tests with 2015's new CPT codes b> b>Q:
Directions on the off-label/modified use of waived blood glucose monitoring systems (BG
Privileging audiologists: Through HR or medical staff?b> b>
Q: Is CMS going to start accepting new Category III CPTb>®>
Q: When a patient presents to the ED and the physician there orders a drug panel, we pe
Improve your patients’ health with the Initial Preventive Physical Examination (IPPE) an
New timeframe for response to additional documentation requestsb>  
CMS updates National Coverage Determination Manual for speech generating devicesb>
CMS extends coverage for aprepitant for chemotherapy-induced emesisb> On
Q:  b>How do I know if my resident is Traditional Part A or has a Medicare Advan
DECEMBER 17, 2014
Common challenges, key solutions b> Editor's note: This article was wr
MARCH 17, 2016
Use of claim adjustment reason (CARC) code 23b> On November 14, CMS issued a transmi
CMS updates Medicare Claims Processing Manual to provide language-only changes f
CMS released 2016 OPPS proposed rule b> On July 1, CMS released CMS-1633-
FEBRUARY 12, 2014
JUSTCODING
When working with stroke patients, you are responsible for several types of observations. First,
April 2014 update of the OPPS b>On February 28, CMS issued a recurring update
NCCI guidelines for Part B Billingb> New coding requirements r
Q: What happened to modifier –JF (compounded drug)? CMS added it in Apr
Updating Shared System and Common Working File to no longer create VA ‘I’ record
Presented on September 17, 2014, 1–2:30 p.m.b> b>Presented by Janet Pot
Presented on September 17, 2014, 1–2:30 p.m.b> b>Presented by Janet Potter,
AUGUST 7, 2014
Presented on September 17, 2014, 1–2:30 p.m. b>>Presented by Janet Potter, CPA, MAS
AUGUST 21, 2014
Q: We had a patient come into our ED with a severe head injury. To protect his airway,
AUGUST 5, 2015
JUSTCODING
JustCoding> conducted
SEPTEMBER 16, 2015
JUSTCODING
By Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CCDS, C-CDIb> &nb
JULY 30, 2014
JUSTCODING
Medicare Shared Systems modified to capture various HIPAA-compliant fieldsb> 
Consolidated billing Q&A with Janet Potterb> Editor's n
DECEMBER 1, 2014
Local chapter activities represent an integral part of ACDIS’ mission to bring together CDI
New final rule refines and redefines medical staff b>
AUGUST 1, 2014
CMS converting most MUEs to per-day editsb> On June 30, CMS released M
Which state doesn’t observe daylight saving time? a. Arizona b. Idaho
Correction made to Provider Reimbursement Manual b>  On October 24,
The MEC meeting will come to order ... hopefully b> What's
OCTOBER 1, 2014
Part 2, Provider Cost Reporting Forms and Instructions, Chapter 11, Provider Reimbur
OIG continues to eye Part A billing, hospitalizations of SNF residents in 2015b>
FEBRUARY 1, 2015
Medicare Shared Systems modifications necessary to capture various HIPAA comp
OIG adds review of Part A claims to the 2014 LTC Work Plan b>
AUGUST 1, 2014
  Note from the Instructor: Overview of the four parts of Medicare, Part I
SEPTEMBER 22, 2015
Greenland is part of the kingdom of which country? a. Denmark b. Norway c
  Poison ivy is part of the family of flowering plants including which of the foll
Q&A: Finance and budgetingb> Editor's note: This month'
SEPTEMBER 1, 2014
Q: b>I am looking for help on reviewing a neonatal intensive-care unit (NICU) death chart for
Q: I have a question regarding a National Correct Coding Initiative (NCCI) edit. I repo
MARCH 4, 2015
JUSTCODING
SNF therapy contracts: Your risks and what you need to know b>
Leadership equation: 7C + 1 = successb> Part 3b: Increasing communication
NOVEMBER 1, 2013
Automation of the request for reopening claims processb> On December 19,
In observance of Thanksgiving, Residency Program Insider will not be published on Friday
NOVEMBER 20, 2019
In observance of Thanksgiving, Nurse Leader Insider will not be published on Thursday, November
NOVEMBER 19, 2019
In observance of the holidays, Residency Program Insider will not be published on Friday, Decembe
DECEMBER 16, 2019
In observance of the holidays, Nurse Leader Insider will not be published on Th
DECEMBER 16, 2019
In observance of Thanksgiving, Residency Program Insider will not be published on Friday, Novembe
NOVEMBER 19, 2020
In observance of the holidays, Residency Program Insider will not be published on Friday, Decembe
DECEMBER 17, 2020
Coordination of Benefits Contractor (COBC) to remove and no longer apply federal tax informati
Part 2, Provider Cost Reporting Forms and Instructions, Chapter 11, Provider Reimbur
As part of the Administration’s goals of better, care, smarter spending, and healthier peop
Contractors given discretion to deny 'related' claimsb> On August 8, CMS
Q:> b>When atelectasis is noted on an ancillary test such as a CT scan of the abdomen or c
JANUARY 28, 2015
JUSTCODING
CMS updates Program Integrity Manualb> On May 2, CMS released a change re
OIG releases its FY 2015 mid-year update b> The Office of Insp
AUGUST 1, 2015
Medicare Shared Systems modifications necessary to capture various HIPAA-compliant fieldsb>
The part of the ear that is visible on the sides of your head is a segment of the external
Q>: We have a resident being admitted with a new G-tube, NPO status and receivi
OCTOBER 31, 2014
FY 2016 Medicare Part A SNF PPS pricer update On June 26, CMS released
Q&A: Long-term care ICD-10 coding specificsb> Editor's
NOVEMBER 1, 2014
CMS revises July 2015 quarterly drug code updatesb> On July 10, CMS resci
With so many moving parts in a healthcare organization, privacy and security incidents are someti
Q: If the physician writes septic shock instead of sepsis, do I need to query for sepsis? Is t
DECEMBER 17, 2014
JUSTCODING
Physician certifications and recertificationsb> by Janet Po
NOVEMBER 1, 2014
Q: We have been watching our payments from Medicare since all the lab bundling was
Butterflies sense taste with which body part? a. Antennae b. Feet
Editor’s Note:b> >The following job posting is an excerpt from the&n
Which symbol was at one point considered part of the English alphabet?  
Terms of use synopsis
SEPTEMBER 4, 2008
CMS offers five solutions to help address inadequate HIPAA Security Rule–requ
SNF therapy contracts: Your risks and what you need to know Q&Ab>
AUGUST 1, 2015
Keeping up with education and training with The Joint Commission and CMSb> Editor
MSP claims?when billers must be detectivesb> By Janet Potter,
DECEMBER 3, 2014
JUSTCODING
The challenges of employed physicians b>
DECEMBER 1, 2014
Ready for ICD-10?b> Ensure your facility's training is on t
Consolidated billing Q&A with Janet Potterb> Editor's note
JANUARY 1, 2015
CMS proposes changes for Accountable Care Organizations b> On December 8,
AUGUST 26, 2015
JUSTCODING
CMS provides examples of claims that are relatedb> On August 8, CMS released a change
Q: We perform electrophysiology (EP) studies in our catheterization lab for outpatients
You won’t find any mention in the Medicare coverage criteria about chronic or nonhealing wo
CMS details changes to reimbursement manualb> On September 19, CMS releas
Q:> Is it is okay to alter, add to, or take back a query form after the physician answers i
Last month, our coverage of HCPro’s latest survey of residency coordinators looked at the l
JANUARY 2, 2020
The Health Insurance Marketplace has become a reliable source of health insurance coverage for m
CMS issues 2014 annual update for Clinical Laboratory Fee Schedule and Laboratory Servi
Q: A few days into the patient’s stay, an order for a Foley catheter was placed f
JUNE 18, 2014
JUSTCODING
CMS releases overview of Physician Feedback and Value-Based Modifier Programsb>
FEBRUARY 11, 2015
JUSTCODING
Business office refresher: Five steps for tracking a SNF leave of absence b>
SEPTEMBER 1, 2014
Disclosing medical errors, Part 2: Some additional practical tips b> by
AUGUST 1, 2014
A closer look at the management of expirabl
Q: We have a debate going on at our facility. We have a new cardiologist who orders an
Implementation of Changes in the ESRD PPS for Calendar Year (CY) 2015b> &
Claims that are relatedb>   On August 8, CMS released a
Cheryl Wang walked, talked, and dressed the part of a doctor-in-training when she gained access l
FEBRUARY 9, 2017
  MedPAC comments on CMS’s proposed rule on Medicare Part C and Part D
JANUARY 5, 2018
Payments to inpatient rehabilitation facilities (IRF) that do not submit required quali
Since its initial inception as part of Section 6106 of the Affordable Care Act, the payroll-based
SEPTEMBER 1, 2017
Change in July 2015 update of quarterly HCPCS drug/biological codeb>  
Automation of the request for reopening claims processb>  
The past and future of credentialing b>
ICD-10-PCS queries will vary by specialtyb> Ask a physician why he or she
SEPTEMBER 23, 2015
JUSTCODING
Implementation of changes in the ESRD PPS for Calendar Year (CY) 2015b> O
Joan L. Usher, BS, RHIA, COS-C, ACEb> is one of the preeminent coding train
Q:> Although I understand that a coder cannot code from a previous encounter’s docume
Q: b>If a patient has hypertensive heart disease or cerebrovascular accident (CVA) with hemi
Q:> Is the statement “please document in a progress note to capture the severity of i
The upsides of change (yes, there are some!)b> Change. It's a
Common SNF billing struggles b>Written by Lisa McIntire and Jul
Q: We consistently hit an edit asking for a modifier on our drug administration service
CMS updates Program Integrity Manualb> On November 26, CMS release
Lost for many observers in last month's end-of-the-year hullabaloo was the annual Gallup Honesty
JUNE 30, 2016
Dear readers, In observance of Thanksgiving, Residency Program Insider wo
NOVEMBER 18, 2016
b>by b>Patricia A. Furci, RN, MA, Esq.b>, and Samuel J. Furci, MPA,
DECEMBER 1, 2014
Simulation training is taking flight in medical learning and practitioner ­comp
CMS releases overview of Physician Feedback and Value-Based Modifier Programsb> On Feb
Physician Feedback, Quality and Resource Use Reports (QRURs) and Value-Based Modifier P
MAY 6, 2015
JUSTCODING
This month, our coverage of HCPro’s latest survey of residency coordinators looks at the du
NOVEMBER 5, 2019
HCPro is working on a new book about OPPE and we’d like you to be a part of it. Our goal fo
NOVEMBER 14, 2013
HCPro is working on a new book about OPPE and we’d like you to be a part of it. Our goal fo
Knowing whether a service invoice for a Part A resident needs to be paid under consolidated billi
AUGUST 29, 2014
A crucial part of any hospital’s emergency plan revolves around communication, because with
MAY 7, 2015
When a body part meets with an external object and the result is an injury, you must explain wh
Q: b>Do you have any advice or guidance on how to conduct chart reviews for beginners in CDI
MARCH 26, 2014
JUSTCODING
2-midnight rule draws concerns about emergency physician admitting privilegesb>
Q: How should the diagnosis of urinary tract infection (UTI) and encephalopathy be sequenced,
MARCH 11, 2015
JUSTCODING
Add or revisit the likelihood of arson as part of your annual hazard vulnerability analysis (HVA)
JULY 28, 2017
MARCH 18, 2015
JUSTCODING
Hospitals did not get any ICD-10 relief as part of
Personal protective equipment (PPE) has become an integral part of day-to-day life at SNFs. While
  Medicare Part A admissions: Best practices for your facility
APRIL 22, 2016
  Q&A: ICD-10: Where are you now? Part 2
  Top five SNF Part A billing issues
AUGUST 12, 2016
  RCS-1: What's changing and how will you be affected? Part 1
DECEMBER 22, 2017
  CMS proposes Medicare Advantage and Part D payment and policy updates
FEBRUARY 2, 2018
Customizing criteria-based core privileges for your o
AUGUST 1, 2014
A new query in our
MARCH 25, 2015
JUSTCODING
AUGUST 6, 2014
JUSTCODING
FEBRUARY 11, 2015
JUSTCODING
Q: We have a new ED director who wants to capture all of our ED visits to be sure we ge
Leverage the CRC's privileging researchb> Locating relevant, u
DECEMBER 1, 2014
AUGUST 27, 2014
JUSTCODING
Two-midnight policy and potential short stay payment solutionsb>  
A report on agency performance on this measure is provided to home health agencies as part of the
Update to CMS publication 100-08, Program Integrity Manual, Chapter 3, section 3
DECEMBER 16, 2015
JUSTCODING
New pathways b> Osteopathic medicine’s bold plan for physician training
JANUARY 1, 2014
FEBRUARY 11, 2015
JUSTCODING
October 2014 update of the ambulatory surgical center (ASC) payment systemb>
CMS update Program Integrity Manual (PIM)b> On November 26, CMS re
Hospice Final Rule for 2017 raises paymentsb>  
JULY 31, 2016
OCTOBER 29, 2014
JUSTCODING
JANUARY 28, 2015
JUSTCODING
A new query in our
APRIL 22, 2015
JUSTCODING
A new query in our
APRIL 8, 2015
JUSTCODING
A new white paper in our S
MARCH 11, 2015
JUSTCODING
FEBRUARY 25, 2015
JUSTCODING
A new query in our
MAY 20, 2015
JUSTCODING
APRIL 2, 2014
JUSTCODING
Q: b>Over the years I have heard differing opinions regarding whether clinical or coding exp
Q:> We have a problem getting our physicians to understand what we are querying for (chroni
Q: We have a problem getting our physicians to understand what we are querying for chronic res
NOVEMBER 19, 2014
JUSTCODING
Two strategies for holding physicians accountable
Proctoring and FPPE: Doctors Hospital of Mante
Q: b>How should the diagnosis of urinary tract infection (UTI) and encephalopathy be sequenc
Barbara Hinkle-Azzara, RHIAb>, vice president of HIM operations
Barbara Hinkle-Azzara, RHIAb>, vice president of HIM operations for HR
MAY 13, 2015
JUSTCODING
Q: Can CDI programs use the information on ambulance forms or trip tickets to abstract from if
FEBRUARY 25, 2015
JUSTCODING
JULY 9, 2014
JUSTCODING
This is the first year that all 50 states have adopted some form of telemedicine coverage. Teleme
Getting it all done when you’re a solo actb>
Bolster billing compliance: Implement a Medicare Part A triple-check processb>
AUGUST 1, 2015
We continue our coverage of HCPro’s latest survey of residency coordinators this month with
SEPTEMBER 4, 2019
JANUARY 21, 2015
JUSTCODING
MACs use the Fiscal Intermediary Standard System (FISS) to process Medicare Part A claims. Hospic
EHR implementation 2010 b>b>survey results: What you have b>
Best practices for managing online criticismb> b>Keep calm and don't
NOVEMBER 1, 2014
Follow bylaws as precisely as possible to avoid
Waiting for the final rule? Here’s a checklist to prepareb
SEPTEMBER 24, 2014
JUSTCODING
Welcome back to our coverage of HCPro’s latest survey of residency coordinators. This month
FEBRUARY 3, 2021
AUGUST 20, 2014
JUSTCODING
  Editor's note: This is part two in a series covering changes to mental disord
JULY 9, 2014
JUSTCODING
Our coverage of HCPro’s latest survey of residency coordinators continues this month with a
NOVEMBER 5, 2020
JULY 15, 2015
JUSTCODING
The Inside Scoop on Additional Development Requests (ADRs)b> W
Q:> Can CDI programs use information on ambulance forms or trip tickets to abstract from if
Interstate Medical Licensure Compact hits state legislaturesb>
NOVEMBER 19, 2014
JUSTCODING
SEPTEMBER 24, 2014
JUSTCODING
Medical staff leaders had a role in QIO efforts
AUGUST 1, 2014
  This article is part two in a series on coding common dermatology conditions
MAY 28, 2014
JUSTCODING
It’s not too early to prepare for ICD-10-CM/PCSb>
DECEMBER 17, 2014
JUSTCODING
JANUARY 14, 2015
JUSTCODING
JANUARY 28, 2015
JUSTCODING
A new query in our
MAY 6, 2015
JUSTCODING
Special Repor
NOVEMBER 11, 2015
JUSTCODING
SEPTEMBER 3, 2014
JUSTCODING
  Bolster billing compliance: Implement a Medicare Part A triple-check process
  The Medicare Meeting: How to ensure proper communication during a resident's Part A stay
NOVEMBER 13, 2015
  Medicare requires a Medicare Part A PPS Discharge Assessment, effective October 1
DECEMBER 7, 2016
  SNF ABNs: Avoiding common errors that lead to Medicare Part A denials
AUGUST 16, 2017
  RCS-1: What?s changing and how will you be affected? Part 2
JANUARY 5, 2018
  CMS invites Medicare Part A providers to learn new Medicare Cost Report e-filing system
OCTOBER 5, 2018
Changes to the definition of one-on-one educationb> On October 31, CMS re
Dear readers,   In observance of the holidays, Medical Sta
DECEMBER 18, 2014
Dear readers,   In observance of the holidays, Residency P
DECEMBER 19, 2014
CMS revisions regarding therapeutic diet orders may give MSPs plenty to chew on b
NOVEMBER 1, 2014
Clearer picture of OASIS-C2 emerges with release of Guidance Manualb>
Medical oncology - Practice area 142
The autopsy dilemma and its implications b> by Patricia A. Fur
SEPTEMBER 1, 2014
Editorial note: Look for more coverage in PPS-Alert’s September issue.
AUGUST 2, 2019
In the PPS, there has been a big problem with coverage of occupational therapy after a single vis
The autopsy dilemma and credentialing, Part 2b> by Patricia
OCTOBER 1, 2014
Medical Staff Briefingb>, wrote the following blog post. Al
When selecting an EHR vendor, don’t forget the add-ons!b>
About Us
SEPTEMBER 4, 2008
NOVEMBER 20, 2013
JUSTCODING
From Part B News, a Simplify Compliance publication HHS Secretary Alex A
NOVEMBER 25, 2020
MARCH 5, 2014
JUSTCODING
JUNE 25, 2014
JUSTCODING
AUGUST 5, 2015
JUSTCODING
AUGUST 26, 2015
JUSTCODING
CMS' star rating system for nursing homes on shaky groundb> b
DECEMBER 1, 2014