Today, the BioTherapeutics, Education & Research (BTER) Foundation was notified that the American Medical Association (AMA), in collaboration with the Centers for Medicare and Medicaid Services (CMS) ...
Although Recovery Audit Contractors (RACs) are not currently evaluating facility evaluation and management (E&M) services, it may not be long before they do. In the 2010 final rule for the hospital ...
How the FDA and CMS worked together on a new approach to paying for digital mental health treatments
Seshamani is the former director of the Center for Medicare. Parris is special assistant in the Center for Medicare. Jacobs is chief transformation officer of the Center for Medicare. Tarver is ...
CMS suggests 1,495 total changes to the ICD-10-CM diagnosis code set in the FY 2023 IPPS proposed rule. Brain illness and injury, with a focus on dementia-related diagnoses, occupy a high volume of ...
The proposed add-on code, currently held by placeholder code 99XXX, will be used to report prolonged office or other E/M services. Providers may need to keep track of two different times when ...
Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same ...
Healthcare coding has fundamentally transformed from volume-driven revenue capture to compliance-first, defensible documentation standards.
The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity. The growth of the Medicare Advantage ...
In the short run, rather than abandoning disease-based risk adjustment in Medicare Advantage, CMS should address coding intensity issues and continue to move to physician-reported encounter data. In ...
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