Insights
Notes on reimbursement, audits, coding, and the rules that move a healthcare revenue cycle.
Ambulance (EMS)
August 18, 2020
Centers for Medicare & Medicaid Services (CMS) recently approved Recovery Audit Contractors (RACs) to audit Specialty Care Transports. The codes impact in this audit are HCPCS A0434 (SCT) and…
Read article
CMS Proposed Rule
August 11, 2020
On August 3 CMS published the proposed policy changes for the Physician Fee Schedule (PFS). The comment period is open through October 5, 2020. At a very high level I have provided the major…
Read article
Home Therapy Services
August 7, 2020
CMS announced several changes in Transmittal 10269 regarding billing home infusions effective January 1, 2021. The Medicare Claims Processing Manual, Ch. 32 § 411 et al. has been updated…
Read article
Inpatient Audits
July 28, 2020
Inpatient audits once again take center stage with the Centers for Medicare & Medicaid Services (CMS). The Office of Inspector General (OIG) has published a new Work Plan item focusing on…
Read article
E/M
May 7, 2020
Historic changes are coming to evaluation and management (E/M) codes effective January 1, 2021. The requirements of leveling Office or Other Outpatient Services will no longer be based on the…
Read article
Nursing Home
April 17, 2020
Nursing homes have long been in the headlines for quality of care issues in some form or fashion. The COVID-19 pandemic has shined a major spotlight on nursing home compliance with state and…
Read article