Blog post
March 13, 2019 / By Richard Fuller, MS
Modern Healthcare recently published another article questioning the utility of the CMS hospital readmission reduction program (HRRP). The article used as its basis two publications, the first of which returned […]
Blog post
Feb. 15, 2019 / By Jean Jones, CPC
One of the things that makes Tom Brady a great quarterback is his ability to think downfield. He’s not just thinking about the current play, but considering all the plays […]
Blog post
Feb. 13, 2019 / By Gretchen Mills
CMS has released the Advance Notice Parts I and II per the annual cycle of Medicare Advantage (MA) regulatory guidelines for the coming year. The Advance Notices provide the parameters […]
Blog post
Feb. 11, 2019 / By Barbara Aubry, RN
On January 24, 2019 CMS released MNL Matters article SE19002, effective January 1, 2018. The change applies to acute care, long-term care and critical access hospitals. As of January 1, […]
Blog post
Jan. 18, 2019 / By L. Gordon Moore, MD
In a Health Affairs blog and an Inside Angle podcast discussion, the health policy expert, physician and self-styled contrarian, Bob Berenson explains why the Evaluation and Management (E/M) coding guidelines […]
Blog post
Jan. 16, 2019 / By Rebecca Caux-Harry
Since the Final Rule for 2019 averted the threat of reduced payment for professional services concerning the -25 modifier, I thought revisiting this troublesome modifier would be a good idea. […]
Blog post
Dec. 19, 2018 / By Barbara Aubry, RN
Yesterday, I saw a new release from CMS clarifying documentation requirements for E/M services in 2019. Little has changed about the data that needs to be collected, but there has […]
Blog post
Dec. 14, 2018 / By Gretchen Mills
MedPAC is the nonpartisan advisory group that provides advice to Congress (and CMS). Although not mandatory, MedPAC recommendations are taken seriously and may be implemented by CMS through regulation or […]
Blog post
Nov. 12, 2018 / By Barbara Aubry, RN
On November 8, 2018 CMS released its Dear Clinician letter providing final decisions on the proposed Evaluation and Management coding changes discussed in a previous blog. The letter is a […]
Blog post
Nov. 7, 2018 / By Sheldon Barlow
Through my work as an auditor and clinical documentation improvement consultant, I have seen firsthand how healthcare organizations are structured and operate. While every organization is unique, they all have […]
Blog post
Oct. 10, 2018 / By Richard Fuller, MS
At the end of September, CMS posted the latest round of data supporting the Hospital Readmission Reduction Program. This is the first year of compliance with the direction of the […]
Blog post
Oct. 5, 2018 / By Barbara Aubry, RN
On October 3, 2018, CMS released CR 10901, Transmittal R829PI, effective October 3, 2018 with an implementation date of January 8, 2019. This is an important modification to the LCD […]
