Proposed OPPS rule offers modest changes.
Lack of new regulations to address presents an opportunity to revisit your processes and strategies for coding and reimbursement. Make sure your charge system is not undervaluing evaluation and management (E&M) services. Your E&M level decision matrix or scoring tools should not use ED procedures as part of their level determination. Check patient acuity levels and nursing documentation if your level distribution does not meet benchmark.
D000553:Ambulatory Care / Q000191:economics*; D014487:Centers for Medicare and Medicaid Services, U.S.; D004636:Emergency Service, Hospital / Q000191:economics*; D006801:Humans; D011445:Prospective Payment System / Q000331:legislation & jurisprudence*; D014481:United States