This week’s Medicare updates includes new information on payment for moderate sedation services, influenza virus vaccine code implementation, new K codes for therapeutic continuous glucose monitors, and more!
This week’s Medicare updates include the release of the 2017 Inpatient Pricer; a decision memo for Hyperbaric Oxygen Therapy; a delay of effective date for the Conditions of Participation for home health agencies; and more!
This week’s Medicare updates include an announcement regarding enforcement discretion on clinical laboratory data reporting; a new OIG resource guide for measuring compliance program effectiveness; a memorandum regarding the final rule adjusting Civil Monetary Penalties for inflation; and more!
This week’s Medicare updates include additional information on denial of home health payments when required patient assessment is not received; Advanced Provider Screening phase 1 go-live; an MLN Matters article on billing for Advance Care Planning claims; and more!
This week's note from the instructor concludes our discussion on multiple notices that hospitals and critical access hospitals (CAH) are required to provide to outpatients and inpatients in particular situations. The focus this week will be on streamlining hospital notification processes to avoid the necessity of recreating the wheel each time a new notice requirement is implemented.
This week’s Medicare updates include an OIG report regarding hospital noncompliance with Medicare Requirements for billing outpatient right heart catheterizations with heart biopsies; a new educational initiative to raise awareness of chronic care management; quarterly updates to the ESRD PRICER; and more!
This week's note from the instructor continues last week's discussion regarding the multiple notices that hospitals and critical access hospitals are required to provide to outpatients and inpatients in particular situations.
No later than Wednesday of this week—March 8, 2017—hospitals (including critical access hospitals [CAH]) are required to meet the newest of Medicare’s numerous hospital notification requirements. Under the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, hospitals must provide both written and oral notice regarding the outpatient nature of observation and the resulting implications to all Medicare beneficiaries who receive observation services for more than 24 hours. This notice must be provided in a prescribed form (the Medicare Outpatient Observation Notice [MOON]) within 36 hours of when observation care began and must meet certain additional requirements with respect to delivery, documentation, etc.
This week’s Medicare updates include the April 2017 Update of the Hospital Outpatient Prospective Payment System; the April 2017 Update of the Ambulatory Surgical Center Payment System; an National Coverage Analysis for Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD); and more!
This week’s Medicare updates include a revision to State Operations Manual Appendix PP; ICD-10 Coding Revisions to NCDs, clarification of payment policy changes for Negative Pressure Wound Therapy using a disposable device and the outlier payment methodology for home health services; and more!
This week’s Medicare updates include the delay of the effective date of the Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model; a quarterly update to the Medicare Physician Fee Schedule database; ICD-10 coding revisions to National Coverage Determinations; and more!
This week’s Medicare updates include Advance Care Planning implementation for OPPS claims, revision to State Operations Manual Appendix PP - incorporating revised Requirements of Participation for Medicare and Medicaid certified nursing facilities, and more!
This week's note discusses the National Correct Coding Initiative (NCCI) Manual, an often overlooked source of guidance for coders and chargemaster professionals when determining correct coding and billing to Medicare.
This week’s Medicare updates include Medicare Outpatient Observation Notice (MOON) instructions, ICD-10 coding revisions to NCDs, a new “K” code for continuous positive airway pressure device bundle, and more!
This week’s Medicare updates include the latest Medicare Quarterly Provider Compliance Newsletter, a proposed decision memorandum for hyperbaric oxygen therapy NCA, new interest rates for Medicare overpayments and underpayments for Q2 2017, and more!
This week’s Medicare updates include corrections to the OPPS, ESRD, and 2017 Physician Fee Schedule final rules, a renewal of the Advisory Panel on Hospital Outpatient Payment and Solicitation of Nominations to the Advisory Panel on Hospital Outpatient Payment, and more!
This week’s Medicare updates include finalization of two new payment models, the January 2017 update of the ASC Payment System, an OIG report on vulnerabilities that remain under CMS' 2-Midnight Rule, and more!
This week’s Medicare updates include Hospital Appeals Settlement Process FAQs, additional opportunities for clinicians under the Quality Payment Program, Conditions for Coverage for End-Stage Renal Disease Facilities interim final rule, and more!
This week’s Medicare updates include the final Medicare Outpatient Observation Notice (MOON), a CY 2017 Update to the DMEPOS fee schedule, information on the CJR Model Skilled SNF 3-Day Rule Waiver, and more!
This week’s Medicare updates include the OIG’s Semiannual Report to Congress, an announcement that the Hospital Appeals Settlement Process is now open, a HCPCS Code Update for Preventive Services, and more!
This week’s Medicare updates include 2017 Annual Update to the Therapy Code List, a Proposed Decision Memo on Leadless Pacemakers, Provider Reimbursement Manual Hospital and Hospital Health Care Complex Cost Report Form CMS-2552-10 updates, and more!
This week’s Medicare updates include the release of the OIG 2017 Work Plan, a CMS memorandum regarding noncompliance of transplant centers, an OIG report on unallowable claims for outpatient physical therapy services, and more!
This week’s note from the instructor discusses the 2017 OPPS final rule’s provisions for implementing Section 603 of the Bipartisan Budget Act of 2015, which requires an alternate payment system for certain off-campus provider-based services.
This week’s Medicare updates include the release of the End-Stage Renal Disease Prospective Payment System final rule, an announcement of the next round of Medicare Recovery Audit Contractors, the Hospital Outpatient Prospective Payment Changes for 2017 final rule, CY 2017 Home Health Prospective Payment System, a Hospital Appeals Settlement Update, and more!
This week’s Medicare updates include the release of FY 2017 Dialysis Facility Reports and End Stage Renal Disease Core Survey Materials; the Denial of Home Health Payments When Required Patient Assessment Is Not Received; a Quality Payment Program fact sheet, and more!
This week’s Medicare updates include Fiscal Year 2017 Inpatient Prospective Payment System and Long Term Care Hospital PPS Changes; Revisions to State Operations Manual for Critical Access Hospitals (CAH) and Swing-Beds in CAHs; and more!
This week’s Medicare updates include CMS’ Quality Payment Program; updates to the interest rate for Medicare overpayments and underpayments; a new initiative to increase clinician engagement; and more!
This week’s Medicare updates include the release of the October 2016 Medicare Quarterly Provider Compliance Newsletter; OIG reports on Medicare payments for clinical diagnostic laboratory tests; Reform of Requirements for Long-Term Care Facilities; and more!
This week’s Medicare updates include a transmittal recurring update notification describing changes to and billing instructions for various payment policies implemented in the October 2016 OPPS update; news about CMS once again allowing some providers to settle inpatient status claims in appeals; an OIG report regarding the improper payment of millions of dollars for unlawfully present beneficiaries; and more!
This week’s Medicare updates include a story about the OIG levying its largest penalty under a corporate integrity agreement against nation's biggest provider of post-acute care; a fact sheet and press release about moving Medicare Advantage and Part D forward; and more!
This week we have an excerpt from Observation Services Training Handbook, written by Janet L. Blondo, LCSW-C, MSW, CMAC, ACM, CCM, C-ASWCM, ACSW. For more information and to purchase, visit the HCPro Marketplace.
This week’s Medicare updates include the October 2016 Integrated Outpatient Code Editor specifications version 17.3; the Medicare Fee for Service (FFS) Recovery Audit program third quarter summary newsletter; and more!
This week’s Medicare updates include a Multiple Procedure Payment Reduction on the Professional Component of certain diagnostic imaging procedures; a new condition code to use when hospice recertification is untimely and corrections to hospice processing problems; and more!
This week’s updates include a notice of proposed rulemaking for bundled payment models for high-quality, coordinated cardiac and hip fracture care; FY 2017 rate update for inpatient psychiatric facilities PPS; and more!
This week’s updates include OPPS 2017 proposed rule; clarifications to stem cell transplantation for multiple myeloma, myelofibrosis, sickle cell disease, and myelodysplastic syndromes change request; and more!
This week’s updates include new waived tests; appeals of claims decisions, revisions to timeliness requirements for forwarding misfiled appeal requests, reconsideration request form, and guidelines for writing appeals correspondence; and more!
This week’s updates include October quarterly update to 2016 annual update of HCPCS codes used for SNF Consolidated Billing enforcement; OIG investigation into improper arrangements and conduct involving home health agencies and physicians; and more!
This week’s updates include change requests regarding payments to home health agencies that do not submit required quality data; the July 2016 update of the ambulatory surgical center payment system; and more!
This week’s updates include a survey and certification letter for the adoption of 2012 Life Safety and Health Care Facilities Code; the July 2016 updates to the Integrated Outpatient Code Editor and hospital OPPS; and more!
This week’s updates include a special edition MLN Matters article regarding rural health clinics HCPCS reporting requirement and billing updates; the Merit-Based Incentive Payment System and Alternative Payment Model Incentive under the Physician Fee Schedule publication in the Federal Register; and more!