This week’s updates include updates to clarify inpatient rehabilitation facility (IRF) claims processing; a revised hospital guidance for pharmaceutical services and expanded guidance related to compounding of medications; and more!
In a surprising announcement on Friday, October 30, the Office of Inspector General (OIG) may have delivered some good news to hospitals who are diligently following prior CMS guidance on billing patients for SADs provided in the outpatient setting.
This week’s updates include an NCD for single chamber and dual chamber permanent cardiac pacemakers; a Medicare Compliance Review of Boca Raton Regional Hospital, Inc., for 2011 and 2012; and more!
Provider-based clinics and departments are increasingly common, but the rules for provider-based billing can often be confusing, especially given recent changes to modifiers and place of service codes.
After years of delays, industry and legislative pushback, and millions spent on technology upgrades and education, ICD-10 is finally here. Even though the fundamental process of coding and billing claims has not changed, providers will still need to pay close attention to their processes to keep the revenue cycle going and reduce denials.
Providers know the drill for addressing and operationalizing CMS' annual IPPS and OPPS updates, along with the usual ICD-9-CM and CPT® coding changes. The industry has become used to CMS' timetable for releasing inpatient and outpatient proposed and final rules and knows that it has to be ready to go live with coding, billing, and operational changes October 1 and January 1, respectively.