ICD-10 & Coding
The Advance Notice with Proposed Payment Updates incorporates risk adjustment policies released earlier this week.
The company had planned to reduce by 25 percent payments for evaluation and management services reported with modifier.
Doctors need to carefully and properly use the HCC codes, which indicate the expected costs for a patient.
This year, getting reimbursed is all about making sure the codes reflect the actual care given.
"Eligible professionals" will submit eCQM data according to the 2015 specifications for their 2016 fourth quarter reporting.
Talix application analyzes member data from claims, electronic medical records and scanned paper documents to increase coding efficiency.
Staffing and productivity issues remain, and with grace periods over, that could spell trouble.
Central Learning will give $5,000 for the inpatient coder with the highest average accuracy and productivity scores across 10 inpatient cases.
Coding quality is more important than ever, but other analytics tools are helping hospitals bridge the gap.
Providers will now be held to using the correct degree of specificity in their coded claims to Medicare and Medicaid.