Billing
Counting units for therapy codes
Read this article to learn how to count units to properly bill therapy HCPCS codes.
End-stage renal disease (ESRD) monthly capitation payment (MCP) claims
Billing ESRD monthly capitation payment claims correctly is important. Read this article to learn more about billing these claims.
What physicians need to know: home health patient-driven groupings model (PDGM)
In November 2018, the CMS finalized a new case-mix classification model, the PDGM, effective beginning January 1, 2020. The PDGM relies more heavily on clinical characteristics and other patient…
Long term care facility prospective payment system standard versus site neutral payment
For discharges on or after October 1, 2015, there are two separate payment categories for long term care hospital (LTCH) patients. This article provides those details.
Physicians: Are you ordering surgical dressings for your patients?
Please review this article from the durable medical equipment (DME) MACs about ordering surgical dressings for your Medicare patients.
Availability of the list of essential medicines considered to be in shortage for the purposes of the recently finalized separate IPPS payment for establishing and maintaining access to essential medicines
In the fiscal year 2025 IPPS and LTCH final rule, CMS finalized a separate payment for establishing and maintaining access to essential Medicines. Read this article to learn more.
Clinicians: Are you ordering diabetic shoes for your patients? – Revised
Please review this article from the durable medical equipment (DME) MACs about ordering diabetic shoes for your patients.
Recommendations regarding the development of a model compliance plan for clinical laboratories
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the…
Recommendations regarding the development of a model compliance plan for clinical laboratories
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the…
Potential assignment violations by clinical laboratories
Some clinical laboratories in our jurisdiction are charging patients prior to performing services, a potential assignment violation. This article outlines Medicare regulations and potential penalties…