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News

CMSA, CCMC enter into collaborative agreement
Source: Revenue Cycle Advisor
In an effort to promote the development of the case management profession, the Case Management Society of America and the Commission for Case Manager Certification recently entered a collaborative agreement surrounding certification and membership.
MedPAC wants to redesign MIPS, unify post-acute payments
Source: HealthLeaders Media
An alternative construct for the Merit-Based Incentive Payment System would withhold a portion of payments for clinicians that they would get back based on their performance on quality metrics.
 

Revenue Cycle Advisor Subscriber Content

Clarifying CMS' policy for long-term infusions via external pumps
Source: Revenue Cycle Advisor
CMS issued SE1609 to clarify long-standing policy concerning external infusion pumps. Apparently, both freestanding physician offices and outpatient hospital departments were treating external pumps as an item of durable medical equipment, even when the physician or hospital department set up the pump on the patient, supplied the drug, and programmed the infusion rate and dose into the pump.
 

Daily Q&A

Q&A: Reporting plural effusion with congestive heart failure
Source: ACDIS

Q: At my institution, we typically do not capture the pleural effusions noted and documented with a congestive heart failure (CHF) exacerbation unless a pleural tap was completed. Coding Clinic states it is acceptable to report pleural effusion if the condition requires either therapeutic intervention or diagnostic testing. All of our CHF exacerbations get at least one chest x-ray. Is that enough “diagnostic testing” to code the secondary condition?

Need expert advice?
Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.
 

Upcoming CMS Events

Tuesday 6/20 -  Special Open Door Forum: The IMPACT Act and Improving Care Coordination
Wednesday 6/28 - CLIA Certificate of Provider-performed Microscopy Webcast
Thursday 6/29 - Improvements to the Medicare Claims Appeal Process and Statistical Sampling Call
 

Product Spotlight

Sepsis: CDI Tools to Clarify Clinical, Coding, and Documentation Requirements

In this 90-minute live webinar, experts James S. Kennedy, MD, CCS, CDIP, CCDS, and Paul Evans, RHIA, CCDS, CCS, CCS-P, break out their dictionaries, dust off their history and rule books, and offer up their clinical acumen to help you decipher documentation improvement opportunities for reporting sepsis and sepsis-related diagnoses.
 

    

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Featured Resource

Innovative Approaches to Optimizing Revenue Cycle Operations

This roundtable examines strategies for reducing claim denials and crafting comprehensive billing statements for patients.
 
 

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