Find-A-Code Focus Newsletter

2016 July Items

CMS extends, expands fraud-fighting enrollment moratoria efforts in six states

July 29, 2016
New demonstration enhances agency’s enrollment and investigative options Today, the Centers for Medicare & Medicaid Services (CMS) announced an extension and statewide expansion of fraud-fighting temporary provider enrollment moratoria efforts in six states, along with a new related dem... Read More

Medicare projects relatively stable average prescription drug premiums in 2017

July 29, 2016
Today, Medicare announced that the average basic premium for a Medicare Part D prescription drug plan in 2017 is projected to remain relatively stable at an estimated $34 per month. This represents an increase of approximately $1.50 over the actual average premium of $32.56 in 2016. “Stable M... Read More

Final FY 2017 Medicare Payment and Policy Changes for Inpatient Psychiatric Facilities

July 29, 2016
OVERVIEW:  On July 28, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a notice updating fiscal year (FY) 2017 Medicare payment policies and rates for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS).  The updates for FY 2017 are summarized belo... Read More

CMS ICD-10 Coding Resources

July 29, 2016
The Centers for Medicare & Medicaid Services (CMS) ICD-10 website features official coding resources that can help you maintain your ICD-10 progress. Highlights include: 2017 ICD-10-CM diagnosis and ICD-10-PCS inpatient procedure code sets and guidelines Specialty Resources Guide ICD-10 Qui... Read More

EIDM Accounts Necessary to Obtain 2015 PQRS Feedback Reports and 2015 Annual Quality and Resource Use Reports

July 27, 2016
CMS will be releasing two reports in early fall that will require Enterprise Identity Management (EIDM) accounts to access. The reports scheduled for release are: PQRS feedback reports depicting your program year 2015 PQRS reporting results, including payment adjustment assessment for 2017. 2015... Read More

SNF QRP: Requirements for the FY 2018 Reporting Year Fact Sheet Available

July 27, 2016
A fact sheet is available with information on requirements for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) FY 2018 reporting year (data collection period October 1 through December 31, 2016). Visit the SNF Quality Reporting Program (IMPACT Act of 2014) webpage for more in... Read More

CMS approves Arizona's plan to re-open CHIP program

July 27, 2016 - By
Today, the Centers for Medicare & Medicaid Services (CMS) announced that it has approved Arizona’s plan to allow new enrollment in the Children’s Health Insurance Program (CHIP) after enrollment was frozen for several years. Now all states provide CHIP coverage to eligible children.&... Read More

ICD-10 Coding: Decide From Two Options When Reporting Diagnosis of Xerostomia

July 27, 2016 - By Christine Taxin
Hint: Don’t forget to report additional codes to identify alcohol or tobacco use. When your clinician diagnoses xerostomia (dryness of the mouth), you will have check the cause for the disturbance in salivary secretion as this has a direct bearing on the code that you will select for the cond... Read More

Meet Dr. Joseph Nichols at PMI's 2016 Conference

July 26, 2016
Get to know one of the most knowledgeable, approachable, and well respected experts in ICD-10 and health information technology at PMI’s Conference this November.   Dr. Nichols will provide a refreshing outlook on the latest in healthcare from a clinician’s point of view. As PMI&rsq... Read More

PMI National Conference in Las Vegas, NV! November 9th-11th 2016

July 19, 2016
1. Get the VIP treatment at the beautiful Flamingo Hotel and Casino Promotion is available now through July 31st to all paid registrants. 2. Take advantage of a new learning experience PMI Conferences are the best place to get access to many experts and learning topics during... Read More

Free Webinar - Maximizing Patient Collections

July 14, 2016
Maximizing Patient Collections - Register now for this FREE ON DEMAND WEBINAR In the era of consumer-driven health care, more financial responsibility is in the hands of the patient - and it’s up to you to collect from them. Industry research reveals that more than 80 percent of self... Read More

Modifications to HCPCS Code Set

July 14, 2016 - By
The scheduled release of modifications to the Healthcare Common Procedure Coding System (HCPCS) code set are available on the HCPCS Quarterly Update web page. Changes are effective on the dates indicated on the update.... Read More

CMS Proposed Policy: -0-day Global Services that are Typically Billed with an (E/M) Service with Modifier 25

July 08, 2016
CMS has noted that several high volume procedure codes are typically reported with a modifier that unbundles payment for visits from the procedure, even though the modifier should only be used for reporting services beyond those usually provided. Therefore, CMS believes the services may be... Read More

Medicare Diabetes Prevention Program Expansion

July 08, 2016
The Diabetes Prevention Program is a structured lifestyle intervention that includes dietary coaching, lifestyle intervention, and moderate physical activity, all with the goal of preventing the onset of diabetes in individuals who are pre-diabetic. The clinical intervention consists of 16... Read More

How The 60-Day Repayment Rule Will Impact You

July 08, 2016
On Feb, 12, 2016, CMS issued its final rule implementing the Affordable Care Act (ACA) requirement that providers and suppliers report and repay overpayments from Medicare, known as the "60-Day Rule."  The ACA requires a person who has received an overpayment to report and r... Read More

Maximizing Revenue, Avoiding Losses

July 07, 2016
July 2016   Eyes Wide Open to the Financial Opportunities  ... Read More

2017 ICD-10- PCS Updates

July 06, 2016 - By Bonnie Schreck
The final version of the 2017 ICD-10- PCS codes has been released by the Center for Medicare and Medicaid Services. Beginning on October 1, 2016, the first day of the federal fiscal year, the use of these codes will become mandatory for hospital inpatient services. The updates for the 2017 ICD-10-... Read More

Oncology Care Model

July 05, 2016
Overview The CMS Oncology Care Model (OCM) is an innovative, multi-payer model focused on providing higher quality, more coordinated oncology care. Under OCM, physician group practices have entered into payment arrangements that include financial and performance accountability for episodes of care s... Read More

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