Tag: coding

Quarterly OASIS Q&As offer detail on wound coding

CMS in its latest quarterly OASIS Q&As provided agencies with details about how to code a specific wound scenario. In Question 1 of the April Q&As, one agency asked CMS about a patient admitted with two distinct areas caused by pressure. Notes the agency: “A wound on the left buttock presents with purple localized discolored […]

CMS final rule makes changes to how physicians are paid, delays E/M coding reform

From The Bottom Line. As part of a final rule published by CMS yesterday to reduce provider burnout, the implementation of coding reforms for physician services known as “Evaluation and Management” (E/M) visits–requirements that haven’t been updated in 20 years–were delayed until 2020 to allow for continued stakeholder engagement. For CY 2019 and CY 2020, […]

Breaking News: CDC releases final list of 2019 ICD-10-CM codes

Brought to you by Home Health Line. Providers will have a total of 473 code changes beginning Oct. 1, including 279 new codes, 143 revised codes and 51 deactivated codes, according to the final list of changes issued June 11 by the Centers for Disease Control and Prevention. The majority of the new codes added […]

Home health: Surgical wound infection codes set to expand dramatically in FY2019

Provided by Home Health Line. Home health coders could have 435 ICD-10-CM code changes to deal with starting Oct. 1, with 247 new codes, 139 revised codes and 49 codes rendered invalid, according to the proposed hospital inpatient prospective payment system rule (IPPS) rule released April 24. One notable code, T81.4xxA (Infection following a procedure, […]

CMS welcomes feedback on proposed case-mix rule, extends comment deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the comment deadline for the advance notice of proposed revisions to case-mix methodology rule from June 26, 2017 to August 25, 2017. The advance notice of proposed rulemaking, titled “Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology,” was published […]

CMS orders post-pay audit of SNF PPS claims

The Supplemental Medical Review Contractor (SMRC) is charged with conducting nationwide medical review as directed by the Centers for Medicare & Medicaid Services (CMS). Topics and timeframes for these reviews are dictated by CMS and are chosen to address specific agency interests regarding coverage, coding, payment, and billing practices. On March 17, 2017, SMRC announced […]

Care area triggers, the CAA process, and how they help the IDT

Editorial Note: This post has been adapted from HCPro’s popular title Long-Term Care MDS Coordinator’s Field Guide by Carol Maher, RN-BC, RAC-CT. For content details and ordering information, visit our Marketplace! What is a care area trigger? Certain single MDS items can trigger a care area. Some care areas are triggered by comparing responses entered […]

Common deficiencies found in MDS 3.0 assessments

In a memo published November 4, CMS highlights common deficiencies and errors found among MDS 3.0 assessments in long-term care facilities. These inaccuracies are reflected in the results of the organization’s FY2015 MDS Focused Surveys. In total, 56 deficiencies (F-tags) were cited. The most frequently cited deficiencies include: F278 – MDS Accuracy F356 – Posted […]

Upcoming webcast: ACOs and Bundling: The New Dating Game

In recent years, the skilled nursing reimbursement system has continually evolved, and to find a suitable partner, you must now develop an appealing profile. In the new ACO payment system, it’s vital to know which skills are most valuable and how diagnosis coding can affect relationships with potential “suitors.” During this program, expert speaker Maureen […]

Job Opening at HCPro: Medicare Regulatory Specialist-PER DIEM (LTC)

We are seeking a Medicare Regulatory Specialist for HCPro-BLR Healthcare to teach our Medicare Boot Camp®-Long-Term Care Version and to partner with fellow regulatory instructors and the HCPro product team to identify and launch new training resources, including boot camps, seminars, elearning, webcasts, and books. The Medicare Boot Camp®-Long-Term Care Version is an intensive, four-day […]