Like other services covered by Medicare, observation must be reasonable and necessary or, in other words, medically necessary. The physician must document that they assessed patient risk to determine that the patient would benefit from observation services.
CMS is proposing several changes to the Comprehensive Care for Joint Replacement (CJR) model, including a three-year extension, in a proposed rule published in the Federal Register on February 24.
This week’s Medicare updates include four new items added to the OIG work plan, a new version of the integrated denial notice form, a transmittal implementing numerous regulatory revisions to the State Operations Manual, and more!
Q: Can we bill for Part A payment for an inpatient stay of less than two midnights if the physician expected the patient to meet the 2-midnight benchmark at the time of admission?
The nuances of documenting and billing for observation services can trip up even the savviest organization. Get a refresher on the basics to ensure your organization avoids common pitfalls.
Sepsis hospitalizations are on the rise and cost Medicare more than $40 billion in 2018, according to a U.S. Department of Health and Human Services (HHS) study.
