In the 2018 OPPS final rule, CMS finalized a change to the current clinical laboratory date of service policies for outpatient molecular pathology tests and advanced diagnostic laboratory tests.
In the current healthcare climate, the issue of medical necessity documentation, or lack thereof, is one of the most common reasons for claim denials. For a service to be considered medically necessary (by a third-party payer), it must be considered a reasonable and necessary service to diagnose and/or treat a patient’s current and/or chronic medical condition.
This week’s Medicare updates include a list of new topics proposed for recovery audit contractor review, a final decision memo on a cardiology device NCD, a diagnosis code update for add-on payments for a blood clotting factor, and more!
This week’s Medicare updates include a fact sheet on the transition to new Medicare cards, a table to clarify alternative payment models’ statuses in the Quality Payment Program, a review of a health system’s compliance with inpatient rehabilitation facility service billing requirements, and more!
At the start of 2018, it’s time to take stock of billing compliance risks that may affect your organization in the new year and patch potential holes before they become a problem.
This week's note clarifies the rules, regulations, and provider considerations to take into accounting following CMS' decision to remove total knee arthroplasty from the inpatient-only list.
