Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Emergency Medicine

Anthem to Implement Post-Pay Reviews for ED Level 5 Claims in Some States; Indiana Currently Excluded

Anthem Blue Cross and Blue Shield recently announced a new policy of post payment reviews of professional ER claims billed with level 5 E/M codes. The new policy is being implemented to “ensure documentation meets or exceeds the components necessary to support its billing,” according to Anthem, and will begin August 1. Indiana and a few other states currently are excluded. READ MORE

MedPAC to Recommend National Coding Guidelines for Emergency Departments

The Medicare Payment Advisory Commission may soon be recommending national guidelines for coding emergency department visits after the group discussed options for slowing the growth of emergency department spending during their March meeting. The recommendation would task the Department of Health and Human Services with addressing the shift toward high intensity service levels by 2022. READ MORE

New Requirements for Indiana’s Prescription Drug Monitoring Program, INSPECT, Begin January 1

By Jan. 1, 2019, all Indiana healthcare providers who hold a controlled substance registration (CSR) must register with INSPECT, the state’s prescription drug monitoring program, and practitioners in hospital emergency departments and pain management clinics must begin querying INSPECT when prescribing opioids or benzodiazepines based on legislation passed during the 2018 General Assembly. READ MORE

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