ICD-10

On August 1, 2018, in Documents, by AQ-IQ LLC

On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures were replaced by ICD-10 code sets. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services. Click […]

Medicaid Program Integrity Initiatives

On June 26, 2018, in Documents, Industry News, by AQ-IQ LLC

Today, the Centers for Medicare and Medicaid Services (CMS) announced new and enhanced initiatives designed to improve Medicaid program integrity through greater transparency and accountability, strengthened data, and innovative and robust analytic tools. Recent years have seen a rapid increase in Medicaid spending driven by several factors, including Medicaid expansion, from $456 billion in 2013 […]

Medicaid and CHIP Scorecard

On June 4, 2018, in Documents, by AQ-IQ LLC

Today, the Centers for Medicare & Medicaid Services (CMS) released the first ever Medicaid and Children’s Health Insurance Program (CHIP) Scorecard, a central component of the Administration’s commitment to modernize the Medicaid and CHIP program through greater transparency and accountability for the program’s outcomes. For the first time, CMS published state Medicaid and CHIP quality […]

CWTC [Episode 36] Debility in IRF, Z51.89, Split Shared Visits with Georgia Medicaid and Fracture Specificity

On April 30, 2018, in CWTC, by AQ-IQ LLC

Welcome to Coffee with the Coder®, our conversation with Paula Digby and her team to address issues, observations and questions for Health Information Management professionals, physicians, auditors, payors and students. You are invited to listen in for ten minutes every other Monday and to submit your favorite questions or comments for Coffee with the Coder® […]

IPPS and LTCH Proposed Rule FY2019

On April 25, 2018, in Documents, Industry News, by AQ-IQ LLC

On April 24, 2018 CMS  issued a proposed rule for FY2019 expected to empower patients through better access to hospital price information, improve patients’ access to their electronic health records, and make it easier for providers to spend time with their patients. The rule proposes updates to Medicare payment policies and rates under the Inpatient […]

IPPS and LTCH Final Rule FY2018

On August 8, 2017, in Documents, Industry News, by AQ-IQ LLC

In this final rule, CMS is increasing the amount of uncompensated care payments made to acute care hospitals by $800 million to approximately $6.8 billion for fiscal year 2018. Uncompensated care represents healthcare services provided by hospitals or providers for which they don’t get reimbursed. Often uncompensated care arises when people don’t have insurance and […]

CMS Moratoria and Demonstration Project

On August 2, 2016, in Announcements, Industry News, by AQ-IQ LLC

CMS announced an extension and statewide expansion of fraud-fighting temporary provider enrollment moratoria efforts in six states, along with a new related demonstration project to allow for certain exceptions to the moratoria and heightened screening requirements for new providers.  CMS also announced it is immediately lifting the current temporary moratoria on all Medicare Part B, […]

2017 Home Health PPS Payment Update

On June 30, 2016, in Announcements, by AQ-IQ LLC

CMS projects that Medicare payments to home health agencies in CY 2017 would be reduced by 1.0 percent, or $180 million based on the proposed policies. The proposed decrease reflects the effects of the 2.3 percent home health payment update percentage ($420 million increase); the rebasing adjustments to the national, standardized 60-day episode payment rate, […]

OIG Work Plan 2016

On November 24, 2015, in Archives, by AQ-IQ LLC

The Work Plan describes the primary objectives and provides for each review its internal identification code and the year in which OIG expects one or more reports to be issued as a result of the review. Get the PDF (80 pages)