Latest subscriber newsletter stories

Review injection and infusion reporting guidance, CPT coding for COVID-19 vaccines

Outpatient coding for injections and infusions can be challenging given the foundational definitions and complex rules that drive reporting of these services. This article breaks down the facility drug administration hierarchy and CPT coding for therapeutic infusions, injections, and hydration.

Audit risk rising amidst the COVID-19 delta surge

Source: Case Management Monthly

Audits are ramping up across the country, creating additional headaches for many healthcare organizations as they simultaneously struggle with the delta variant of COVID-19.

UnitedHealthcare switches from Milliman Care Guidelines to InterQual

Source: HIM Briefings

UnitedHealthcare recently transitioned its utilization management approach for all of its health plans from Milliman Care Guidelines to InterQual criteria. Learn how this change could have far-reaching impact on hospitals.

HHS summer cybersecurity newsletter breakdown: Access control

Source: Briefings on HIPAA

HHS recently issued its Summer 2021 OCR Cybersecurity Newsletter, covering the topic of controlling access to ePHI. HHS officials cited a Verizon 2021 Data Breach Investigations report that found 61% of analyzed data breaches in the healthcare sector were perpetrated by external threat actors and 39% were carried out by insiders.

Note from the instructor: CMS reverses elimination of inpatient-only list

Source: Medicare Insider

This week's note from the instructor discusses CMS' proposal in the CY 2022 OPPS proposed rule to reverse course on CY 2021 changes to the inpatient-only list and the ambulatory surgical center covered procedures list.

Upcoming CMS Events

Tuesday and Wednesday, 9/14 and 9/15 - ICD-10 Coordination and Maintenance Committee Meeting

Wednesday, 9/22 - Virtual Meeting of the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC)

Product Spotlight

2022 IPPS Final Rule: Compliant Revenue Strategies

During this 90-minute session with live Q&A, expert speaker Judith L. Kares, Esq., will describe the most significant changes identified in the FY 2022 IPPS final rule, including updated reimbursement information, reporting measures, new technologies, operating and capital rates, and changes to quality and interoperability programs.

This week in Medicare

This week's Medicare updates include an announcement on expanded payments for at-home COVID-19 vaccinations, dates for implementation of the Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transports nationwide, an OIG review of phlebotomy travel allowances, and more!

What is Revenue Cycle Advisor?

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Don’t just read the news—read our in-depth expert analysis on the latest rules and regulations.

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