Blogs

Keeping up with MS-DRG Revisions

Rayellen Kishbach's picture

CMS has issued two errata and correction notices for how MS-DRG logic functions in FY2017. These changes may impact payment. This article highlights a few examples.

It is important to note that CMS published v34 r2 in time for implementation on 10/1/2016, but the v34 r3 was released after claims for FY2017 had begun, so improper payments may have occurred.

Be Prepared for Changes in Billing Discarded Drugs/ Biologicals

Christina Panos's picture

By Christina Panos, RHIA, CTR

Original post on 6/9/2016 updated on 6/10/2016 to reflect announced delay.

The Centers for Medicare and Medicaid Services (CMS) has maintained a long-standing policy that provides payment for the discarded portion of single-use vials/packages.  While coverage is not changing, the associated drug wastage billing requirements are about to change.

Supporting Compliance in the New World of Remote and Outsourced Coding & Billing.

Rayellen Kishbach's picture

According to a recent HIM Benchmark Report, HIM department managers equally ranked Coder Productivity, Quality, and Managing Financial Metrics as their biggest challenges, while that same report noted that close to 60% of HIM professionals outsource a portion of their coding needs. Even without direct outsourcing, we notice an increase in the opportunity to do coding and billing work remotely.

Understanding MS-DRG Grouping under ICD-10

Rayellen Kishbach's picture

Now that ICD-10 is in full swing, we are seeing a lot of activity with providers, payers, consultants and regulators who need to understand how Acute Inpatient and Long Term Care Hospital claims "behave" when the claim is coded in ICD-10. This includes both prospective and retrospective review of claims scenarios to understand MS-DRG grouping. This article offers a basic primer on MS-DRG grouping logic, and research techniques for using related MediRegs Coding Suite tools.

OIG Releases New Compliance Oversight Document for Health Care Governing Boards

Darci Friedman's picture

On April 20th, Daniel R. Levinson, the Inspector General for the Office of Inspector General ("OIG"), U.S. Department of Health and Human Services ("HHS") delivered an address at HCCA's 19th Annual Compliance Institute. He was his usual captivating, thoughtful self, delivering a few gems for those in attendance. One of those gems was that that day the OIG released a new document for the industry titled: Practical Guidance for Health Care Governing Boards on Compliance Oversight ("Practical Guidance").

OCR Releases a New Version of Guide to Privacy and Security of Electronic Health Information

Darci Friedman's picture

The Office of Civil Rights recently released Version 2.0 of its' Guide to Privacy and Security of Electronic Health Information ("Guide"). This new version of the Guide provides updated information about compliance with the Medicare & Medicaid Electronic Health Record (EHR) Incentive Programs' privacy and security requirements as well as the HIPAA Privacy, Security, and Breach Notification Rules. You can access the updated document on your MediRegs product, with the OCR data in the HIPAA Library.

Be There or Be Square: HCCA's Annual Compliance Institute

Darci Friedman's picture

HCCA's Annual Compliance Institute is just 25 days away! I attend the Compliance Institute every year, but this year I am really looking forward to it. Part of my eagerness is motivated by the fact that I write this from the greater Boston area. This has been a really rough winter for even the heartiest of New Englanders and it just seems as though there is no end in sight. It is a cold 21 degrees today. Brrrrr!  Lake Buena Vista, Florida - where this year's Compliance Institute is being held is projected to have a high in the mid-eighties today.  I'll take it!

Gain clarity into 2015 IPPS & OPPS Final Rules

Every year we provide in-depth learning covering both the Inpatient Hospital PPD (IPPSFinal Rule and the Outpatient Prospective Payment System (OPPS) Final Rule. This year we covered the important issues in these Final Rules, as well as provided practical suggestions for how providers should respond to the changes from these new Rules, in two online webinars.

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