Oceanside Medical Group, a clinic providing mental health services in Santa Monica, California, is disputing an Office of Inspector General (OIG) report that estimated the group received $2.6 million in overpayments for psychotherapy services by failing to comply with Medicare billing and documentation requirements.
This week’s Medicare updates include information on Hurricane Dorian waivers for Florida, the Carolinas, and Georgia; a final rule on provider enrollment changes aimed at minimizing the risk of fraudulent practices; the October update of the ambulatory surgical center payment system, and more!
Q: How should we handle canceled inpatient-only procedures? Are these are still coded to the full intended procedure under OPPS and modified with a -73 or -74 modifier? Most of these cases result in changed orders to outpatient due to the patient being discharged the same day. Can the original inpatient order be used?
The October 2019 OPPS quarterly update reassigned certain injections from non-payable to separately payable. CMS also revised the status indicators for several recently approved advanced diagnostic laboratory tests (ADLT).
