This week’s Medicare updates include proposed and final rules for several of Medicare’s prospective payment systems, the 2020 ABN form for download, an article about compliance with the three-day stay rule for SNF admission, and more.
CMS is proposing several revisions to its clinical diagnostic laboratory date of service (DOS) policy in the FY 2020 OPPS proposed rule, including requiring ordering physicians to determine whether tests are intended to guide treatment during a current or future outpatient encounter.
Q: We have a case in which there was an observation order for a patient with Medicare Part B as a primary insurance and Cigna as a secondary insurance. If this is billed to Medicare and denied, can the secondary insurance be billed?
The January 1, 2020, deadline for reporting Appropriate Use Criteria (AUC) for advanced diagnostic imaging is fast approaching—but organizations can’t wait until the new year to prepare.
Behavioral health is a highly specialized area of coding that many coders and billers are unfamiliar with. There are hundreds of ICD-10-CM codes for mental disorders with unique characters to specify symptoms and complications.
Even if a hospital is not a teaching hospital, it may have services that require National Clinical Trial (NCT) reporting. It is logical for revenue integrity leadership to own this issue, but an explanation of the requirements for NCT reporting should be shared with all staff within the revenue cycle so there is a better appreciation of the fact that clinical trial billing rules apply more broadly than merely just to research or clinical trial studies.
