As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption. That would be the International Classification of Diseases 11th Revision, otherwise known as ICD-11, which was released by the World Health Organization (WHO) in June after a decade in development. And U.S. officials are already considering a switch to the codes—for use on death certificates.
Editor’s note: The following is reprinted with permission from a post on Reg’s Blog dated October 2, 2018, the senior and postacute healthcare news blog written by Reginald M. Hislop III.
In the 2019 OPPS (outpatient PPS) proposed rule, CMS included a site-neutral payment provision. With the comment period closed and the lobbying against such a provision fierce, it will be interesting to see where CMS lands in terms of the final OPPS rule: Will they maintain, change, or abate? The one thing that is for certain, regardless of the fate of this provision, is that site-neutral proposals/provisions are advancing.
Per the 2018 CPTÒ Manual, nursing facility services are reported using CPT codes 99304–99318. Notice that the heading for this category is Nursing Facility Services rather than Skilled Nursing Facility Services. It would be clearer if the heading was Skilled Nursing Facility Services as these E/M services can be administered to patients in skilled nursing facilities (SNF), intermediate care facilities, psychiatric residential treatment centers, or long-term care facilities.
A best practice is a technique or methodology that, through experience and research, has proven to reliably lead to a desired result. In any industry, best practices are developed over time. Professionals involved in the revenue cycle of a long-term care (LTC) facility must have a solid understanding of the fundamentals of claims processing as they relate to the Medicare regulations and the facility’s state Medicaid reimbursement system.
Deborah Collum, national director of revenue cycle management for Covenant Retirement Communities in Skokie, Illinois, uses one word to prepare people for how they’ll feel during their company’s first monthly accounts receivable (AR) meeting: naked.
“When my company first started conducting AR meetings, they were an hour and a half long, but now we’ve pared them down to about 20 minutes because our AR is so clean. You have to identify the ugly before you can get to the pretty,” she says.