Simplifying the Use of Condition Code 44 versus Part A-to-Part B Rebilling

Published: Wed, 05/08/19

Not infrequently, in the process of utilization review (UR), we run into situations in which, as physician advisors, we get to review Medicare cases that do not match their original “label” (i.e. the initial status selection was likely not a proper one).

The Role of HIM Professionals in the Revenue Cycle

As we continue this segment on health information management (HIM) in the revenue cycle, I’d like to share some thoughts I discussed at the recent Missouri Health Information Management meeting.

CMS to revamp coding for new medical technology

CMS Administrator Seema Verma announced Thursday the agency will overhaul coding regulations that she argues have hindered beneficiary access to new medical technologies. Medical device companies will now be able to apply for a new...

Rare and strange ICD-10 codes

ICD-10 is a set of around 70,000 diagnosis codes. ICD stands for International Statistical Classification of Diseases and Related Health Problems. The verbosity of the name is foreshadowing. Some of the ICD-10 codes are awfully specific, and bizarre.

For example...

Sweeping CC Designation Changes Noted in the CMS 2020 IPPS Proposed Rule

The 2020 Proposed Inpatient Prospective Payment System Rule (IPPS) came out on April 23, 2019, and we need to mobilize. The comments page says we only have until 11:59 pm on May 3, 2019, although the rule itself quotes June 24 as the deadline to provide CMS with comments. It is imperative that...

Judge says AMA is right: Title X gag rule violates medical ethics

“This is madness,” wrote U.S. District Judge Michael McShane in Portland, Oregon, in a scathing rebuke of the Trump administration’s new Title X regulations that includes a gag rule dictating what physicians must and must not say to their patients in the...