The Centers for Medicare & Medicaid Services (CMS) has increased its surveillance activity of hospitals and updated its Conditions of Participation (CoPs) for hospitals. Do you think your hospital is ready and knows what to do if a CMS surveyor shows up at your establishment More..
After months of wrangling, Republicans in the U.S. Senate on July 18 announced more defectors who said they would not support the Senate’s current version of healthcare reform legislation. This marks yet another failure to make good on their leadership’s promise to dismantle the Affordable More..
Procedures and services related to the foot are very specific and can be quite confusing because of all the medical necessity requirements and the restrictions on the conditions that can be treated. Diagnosis coding for podiatry requires specific training so that you can you understand More..
Physician practices’ reimbursements are shrinking from all insurance companies, especially Medicare. Patient loads are smaller and operating costs are skyrocketing due to the present economy. Every medical practice should be looking at additional revenue opportunities with its own patient base while maximizing patient clinical outcomes. More..
The modifier, a two-digit code additional to the CPT codes, can be a powerful tool to ensure providers get paid for services that are not normally performed together or which may be in addition to the primary service provided. In order to bill for services More..
About a year ago, the Centers for Medicare & Medicaid Services (CMS) issued its finalized infection control worksheet for surveyors to use in inspections of hospitals. This surveyor worksheet can be used to assess compliance with the infection control Conditions of Participation (CoPs). For the More..
Selecting appropriate Current Procedural Terminology (CPT®) codes for injection and infusion can be a daunting task, both for beginners and pro outpatient coders. Outpatient coders must be well versed with the CPT® codes for injections and infusion services provided in both the oncology unit as More..
The home health care industry has not seen a change in Medicare’s Conditions of Participation (CoPs) in three decades. However, in January 2017, the Centers for Medicare & Medicaid Services (CMS) finalized new standards for improving the quality of health care services for home health More..
Fracture care is a major part of orthopedic care, whether it takes place in a primary care or family practice setting, or a hospital or emergency room. It also happens to be an area where providers tend to lose a lot of money due to More..
“Medical necessity” is generally understood to refer to the requirement that medical services be justifiably reasonable, necessary and appropriate and is inextricably linked to the modern phenomenon of payer-based healthcare. But there’s no universally accepted definition of the term, and providers, private payers, CMS and More..