CMS has been making it clear over the years that packaging would become a larger and larger part of OPPS, and in calendar year (CY) 2014 CMS made good on this.
When an NCCI edit occurs on a claim, providers can go directly to CMS’ website and download the latest edits to pinpoint why the edit occurred and what codes may be conflicting.
In addition to increased packaging and collapsing of E/M clinic visit level CPT® codes in the 2014 OPPS -Final Rule, CMS made additional changes that will have an immediate impact on reimbursement
In the 2014 OPPS Final Rule, CMS offered the following -example for billing a laboratory test on the same date of service as the primary service, but ordered for a different purpose than the primar
Last week, CMS released MLN Matters article MM8572 with billing instructions for laboratory services paid under either OPPS or the Clinical Laboratory Fee Schedule (CLFS). Prior to this guidance, I had received several questions from clients and past students regarding rural sole community hospital (SCH) add-on payments for lab services. Click the link above for more information and an in-depth analysis.
