Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?
Medicare increased payments for patients diagnosed with the novel coronavirus (COVID-19). MLN Matters SE20015, implements provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act for hospitals paid under the Inpatient Prospective Payment System (IPPS), long-term care hospitals (LTCH) PPS, and inpatient rehabilitation facilities (IRF) PPS.
Clinical validation reviews and queries ensure that the documented diagnoses and clinical indicators hold up to inspection. Use these strategies to head off clinical validation reviews and improve documentation.
The CDC estimates there are an estimated 35,900 deaths a year from antibiotic-resistant infections. Learn how to improve coding and documentation of these infections.
Q: Can a hospital bill for a nutritionist and a dietitian deliver diabetes self-management training (DSMT) via telehealth on a UB claim? Nutritionists and dietitians are on the list of distant site practitioners, although registered nurses are not.
