Tag: CMS

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How this health system reduced readmission rates to me...

An estimated 82 percent of hospitals receiving Medicare and Medicaid payments in fiscal year 2019 are expected to have their payments reduced because their...

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Personalized patient estimates create better experienc...

As of January 1, 2019, thousands of hospitals in the U.S. are being required to post an online list of the cost of their...

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DHHS’ OIG Mid-Year Work Plan...

The U.S. Department of Health and Human Services (DHHS) Office of Inspector General (OIG) recently released an updated Mid-Year Work Plan for fiscal year...

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JW Modifier: Drug Amount Discarded/Not Administered to...

Effective January 1, 2017, when processing claims for Part B drugs and biologicals, except those provided under Competitive Acquisition Program (CAP), the use of...

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New Unspecified Diagnosis Codes Excluded by CMS for 20...

On May 26, Centers for Medicare & Medicaid Services (CMS) outlined additional unspecified diagnosis codes the agency is excluding from both ICD-9 and ICD-10...

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Add-On Codes: CMS and Payment Policy...

An add-on code is a HCPCS/CPT code that describes a service that, with one exception (see next paragraph), is always performed in conjunction with...

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National Correct Coding Initiative Edits (NCCI)...

Back in 1996, the Centers for Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative (NCCI) to promote correct coding and prevent...

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Review of Current Medicare Administrative Contractors...

Since Medicare’s inception in 1966, private health care insurers have processed medical claims for Medicare beneficiaries. Originally these entities were known as Part A...

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