The acute kidney injury (AKI) dialysis payment rate is $232.37 for CY 2018, as updated by CMS in the 2018 End-Stage Renal Disease Prospective Payment System (ESRD PPS)
This week’s Medicare updates include new hospital appeals settlement options, revisions involving the addition and deletion of ICD-10-CM codes from certain NCDs, details on the partial settlement of a 2-Midnight policy court case, and more!
Currently, there are no national guidelines for how facilities should assign evaluation and management (E/M) levels in the emergency department (ED). Under Medicare’s ambulatory payment classification (APC) system, facilities create their own internal guidelines for determining the ED visit level, and each facility must follow its own system to demonstrate compliance.
A Comprehensive Error Rate Testing (CERT) study showed insufficient documentation causes most improper payments for arthroscopic rotator cuff repairs, according to the October 2017 Medicare Quarterly Compliance Newsletter.
This week's note reviews two major policy changes from the OPPS and MPFS final rules: the reduction in reimbursement for 340B drugs and the reduction in the payment adjustment for non-excepted off-campus provider-based departments.
