This week’s Medicare updates include a Special Edition MLN Matters article on appropriate use criteria changes, updates to beneficiary notice forms, a beta version of an ICD-10-CM browsing tool, and more!
Q: What is the process for submitting a claim for an inpatient hospitalization when our utilization review committee determined after discharge that the inpatient admission was not medically necessary?
This week’s Medicare updates include transmittals on new provider specialty codes for opioid treatment programs, the implementation transmittal for the Ambulatory Surgical Center Payment System, correction notices for the 2020 Medicare Physician Fee Schedule final rule and Outpatient Prospective Payment System final rule, and more!
One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.
If you aren’t yet confused by the site-neutral payment policy changes prompted by CMS apparently ignoring both Congressional intent and the American Hospital Association (AHA) and other impacted hospitals filing suit, you are likely to become so now.
