UnitedHealthcare (UHC) is suspending certain prior authorization requirements for in-network hospitals and skilled nursing facilities through January 31.
This week’s Medicare updates include three advisory opinions, billing information for Most Favored Nation model drugs, the January 2021 OPPS update, and more!
The Office of Inspector General (OIG) will be conducting a second round of audits to determine whether acute care hospitals are being inappropriately reimbursed for outpatient services provided to inpatients, according to a recent update to the OIG’s Work Plan.
Hospital coding for pregnancy-related services requires a detailed understanding of the CPT® global obstetric (OB) package and ICD-10-CM coding guidelines for maternal care management. This article details hospital coding for pregnancy and delivery complications and procedures used to treat them.
Section 1862 (l) and Section 1869 (f)(2)(B) of the Social Security Act (the Act) sets forth general procedures to develop and evaluate Medicare coverage determinations that are either adopted nationally by CMS or created and applied locally by a Medicare Administrative Contractor (MAC) within the MAC’s own jurisdictional boundaries.
