Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use ICD-10-CM code Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e., C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?
In the 2020 Medicare Physician Fee Schedule (MPFS) final rule, CMS put a stamp of approval on its previous proposals to overhaul how medical practices will report office and outpatient E/M services in 2021.
The government is starting a trial program in the District of Columbia that aims to improve treatment for Medicaid beneficiaries struggling with serious mental illness or substance use disorders.
This week’s Medicare updates include a variety of new initiatives aimed toward improved safety and quality at nursing homes, updated fact sheets on opt-in and voluntary reporting procedures for MIPS, a comment request on an information collection regarding the MOON, and more!
Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a November 1 report from the Office of Inspector General (OIG).
