The conference is just 25 days away! If you haven’t registered yet, there’s still time. Click here to read a note you can tailor to your needs and send to your...Read More »
Clinical validation denials (CVD) result from a review by a clinician, such as a registered nurse, contractor medical director, or therapist, who concludes, retrospectively, that a patient was not really afflicted by a condition documented in...Read More »
Live onsite scoring for the CCDS exam began again last Friday, April 15. This is welcome news for those waiting patiently for exam results and for those waiting to schedule their credentialing test until onsite scoring became available.
CMS issued the fiscal year (FY) 2017 IPPS proposed rule yesterday with updates to several quality initiatives. Payment rates will increase by 0.9% in FY 2017, after inflation and other adjustments for hospitals participating in the Inpatient Quality Reporting (IQR) Program and meaningful EHR use...Read More »
Evaluation and management (E/M) services payments—the principal payment method for physicians—resulted in a projected $4.5 billion in improper Medicare payments in 2014, accounting for 9.3% of the overall improper payment rate for Medicare fee-for-services, according to the April 2016 Medicare...Read More »
CMS launched a voluntary five-year physician payment program dubbed the Comprehensive Primary Care Plus (CPC+) model, according to an April 11 press release. The CPC+ program builds on CMS’ Comprehensive Primary Care initiative launched in 2012, and allows participating practices to opt into one...Read More »
Organizations should be able to mine computer-assisted coding (CAC) or EHR software to identify cases for review related to the new Sepsis 3 criteria, published last month. System logic should cull records with a discrete lab value of a serum lactate level greater than 2 mmol/L. As a second step...Read More »
Q: I have a patient with Stage 4 lung cancer that presented with fatigue, cough, and loss of appetite. Initially, they thought he had pulmonary nodular amyloidosis (PNA) but when they did an echo-cardiogram on day one they found a pericardial effusion (malignant). The initial report says...Read More »
