This week’s Medicare updates include the elimination of routine reviews including documentation compliance reviews and instituting three medical reviews; new guidance for outpatient facility claims; standardization of demand letter language; and more!
This week’s Medicare updates include the July 2017 update to the Ambulatory Surgical Center Payment System; the Spring 2017 Semiannual Report to Congress; a new Targeted Probe and Educate Pilot; and more!
There is an extensive list of coverage requirements that must be met to furnish outpatient services to Medicare beneficiaries. Hospitals may find that certain coverage requirements for therapeutic and diagnostic service are more difficult to meet than others, especially in off-campus provider-based departments.
CMS issued SE1609 to clarify long-standing policy concerning external infusion pumps. Apparently, both freestanding physician offices and outpatient hospital departments were treating external pumps as an item of durable medical equipment, even when the physician or hospital department set up the pump on the patient, supplied the drug, and programmed the infusion rate and dose into the pump.
When CMS introduced Hierarchical Condition Categories (HCC) with risk-adjusted scores, Ochsner Health System began efforts to educate providers and improve documentation across its many facilities.
