At AAPC’s annual Healthcon conference in Orlando, Florida, Dr. David Zielske (also known as Dr. Z) had a session on Interventional Radiology, Cardiology and Vascular Surgery coding. As you can […]

During the first 12 months of ICD-10, the Centers for Medicare and Medicaid Services (CMS) was lenient with ICD-10 coding specificity to allow providers to become accustomed to the new […]

Like most of you who participated in the ICD-10 Coordination and Maintenance Committee held last week at CMS headquarters in Baltimore, I watched the live webcast on YouTube. I also […]

In this blog, we return to how socioeconomic status is accounted for when measuring patient outcomes. We have actively participated in the debate on how to identify potentially preventable readmissions […]

I review OIG updates as they are released and I saw something last week that unfortunately, I did not find surprising. Per the OIG report: “Payments made to providers for […]

Note: I started this blog on Monday morning, when an agreement to end the shutdown was still being worked out. Now that government is funded, the blog looks like old […]

You’ve probably noticed it’s been a bumpy regulatory ride for bundled payments of late. On November 30, 2017, CMS cancelled two “mandatory” bundled payment programs that targeted cardiac and joint […]

I attended the January 9, 2018 CMS Medicare Learning Network conference call covering the logistics of the settlement process offered by CMS for providers with pending appeals. This impacts: “The […]

On December 27, 2017, CMS published Part 1 of this year’s Medicare Advantage (MA) Advance Notice highlighting proposed changes in MA payments for 2019. CMS requires comments on this Part […]

A primary objective of the Triple Aim for healthcare payers is to reduce costs associated with inefficient, ineffective, or medically unnecessary care. The accountable care organization, or ACO, has been […]

“The Medicare Payment Advisory Commission is pushing for the immediate repeal and replacement of a Medicare payment system that aims to improve the quality of patient care.” – Modern Healthcare […]

Staying current with the CMS Quality Payment Program is essential for providers.  My previous blog—provided an overview of the program; then, on June 20, 2017, CMS announced changes that represent […]