CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.
Trouble viewing? See it online! Monday, November 4, 2019
 

News
2020 OPPS final rule: Site neutral and 340B drug discount cuts to continue, price transparency policy remains opaque
Source: Revenue Cycle Advisor
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.
2020 Medicare Physician Fee Schedule confirms E/M overhaul, updated rates, and new codes
Source: Part B News
The vast reshaping of E/M documentation standards and payment changes took a significant step closer to reality as CMS put a stamp of approval on its previous proposals to overhaul how medical practices report office and outpatient E/M services in 2021.
CDC proposes sepsis coding changes, requests feedback
Source: ACDIS
The Centers for Disease Control and Prevention (CDC) released a proposal for changes to ICD-10-CM sepsis related codes after receiving numerous questions and comments about the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) published in 2016.
 

Revenue Cycle Advisor Subscriber Content

Staying HIPAA compliant while working remotely
Source: Revenue Cycle Advisor
Working remotely has many benefits for employers and employees. A Stanford study found that working from home boosts employee productivity, which was attributed to taking fewer breaks and sick days and working in quieter, more convenient work environments.
 

Daily Q&A
Q&A: Resubmitting denied claims
Source: Revenue Cycle Advisor
Q: How should we handle denied claims when the payer refuses payment under the billed status? Do we need to document that the status was changed only because the payer did not agree to any other options?

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Upcoming CMS Events
Tuesday, 11/5 - Submitting Your Medicare Part A Cost Report Electronically Webcast
Wednesday, 11/6 - Atherectomy: Comparative Billing Report Webinar
Wednesday, 11/6 - Home Health, Hospice, and DME Open Door Forum
Thursday, 11/7 - CMS Ambulance Open Door Forum
 

Product Spotlight

2020 ICD-10-CM/CPT Reporting for Obstetrical Services

During this 90-minute webinar, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, will review outpatient coding for the global OB package and separately identifiable pregnancy, delivery, and postpartum care. Webb will also review commonly encountered medical necessity challenges that occur with clinical documentation and billing for OB/GYN diagnoses.
 

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