Latest subscriber newsletter stories

2023 IPPS proposed rule: CMS proposing modifications to data used for rate setting

Source: NAHRI

Among the proposed changes, many of which affect quality and data reporting programs, are proposed changes to claims data used for rate setting, a delay of the three-way split criteria for MS-DRGs, and more.

Applying HCPCS modifiers -GA, -GX, -GY, and -GZ for non-covered services

Source: Briefings on APCs

Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.

Medication-assisted treatment programs can help with substance use disorders

Source: Case Management Monthly

Since 1999, more than 760,000 Americans have died from a drug overdose—the vast majority of them related to an opioid. Hospitals and case managers have found themselves on the front lines of the crisis.

CDI's mission: Interdepartmental education and collaboration

Source: HIM Briefings

CDI’s work touches nearly every facet within an organization, from the business departments (e.g., financial, contracts, denials management, etc.) to clinical initiatives.

Q&A with Rebecca Herold

Source: Briefings on HIPAA

We caught up with privacy expert Rebecca Herold, FIP, CIPM, CIPP/US, CIPT, CISSP, CISM, CISA, FLMI, CEO and founder of The Privacy Professor, and co-founder of Privacy & Security Brainiacs, to ask her some important HIPAA compliance questions.

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Product Spotlight

NCCI Modifier Review: Navigate Chapter-Specific Coding and Reporting Guidance

During this 60-minute webinar, Sarah L. Goodman, MBA, CHCAF, COC, CHRI, CCP, FCS, will review the latest NCCI guidance for hospital reporting. Listeners will learn when to use modifiers to prevent and override procedure-to-procedure edits and Medically Unlikely Edits, tips for reporting and billing, and case scenarios for the most challenging modifiers such as -25 and -59. The program will also provide an overview of when and how to report new HCPCS modifiers

This week in Medicare

This week's Medicare updates include the FY 2023 SNF PPS Proposed Rule, the renewal of the COVID-19 PHE, updated code descriptors for the Prior Authorization for Certain Hospital Outpatient Department Services program, and more!

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