This week’s Medicare updates include corrections to the IPPS final rule; corrections to the Skilled Nursing Facilities Prospective Payment System final rule; year 3 baseline data on Medicare payments for clinical diagnostic laboratory tests; and more!
The fiscal year (FY) 2018 IPPS final rule included updates to payment rates and quality initiatives, as well as an ample amount of code changes and updates to ICD-10-PCS non-operating room (OR) to OR code designations.
This week's note looks at how to accurately calculate new technology add-on payment charges and ensure your facility is appropriately reimbursed for them.
Q: Our team had a recent case that involved a small midline episiotomy which extended to a second-degree laceration which was repaired with 3-0 vicryl rapide sutures. Would we code the episiotomy and repair or just the repair, and why? We are considering ICD-10-PCS code 0KQM0ZZ (Repair of the perineum muscle, open approach) and/or 0W8NXZZ (Division of the female perineum, external approach).
On August 14, CMS published the FY2018 Inpatient Prospective Payment System Final Rule; with it came discussion and a notice in regards to the 96-hour certification requirement for critical access hospitals (CAH).