CMS’ proposal in the 2020 OPPS proposed rule mandating the disclosure of negotiated charges between hospitals and payers may exceed the agency’s legal authority, the American Hospital Association (AHA) stated in its comments on the proposed rule.
This week’s Medicare updates include a final rule on revisions to discharge planning requirements, a handful of resources regarding a fraudulent genetic testing scheme, revisions to quality policies and procedures for laboratories, and more!
CMS issued a final rule last week reforming the discharge planning process for hospitals, critical access hospitals, and home health agencies that participate in Medicare and Medicaid.
Managers should not assume that they can review every guideline, every item in Coding Clinic, or every coding-related issue targeted by the OIG or Recovery Auditors. However, those issues that have been identified as the result of denials, external coding audits, or quality initiatives should surface to the top of the audit list for the coding manager.
Device-dependent edits require reporting a device code with procedures CMS has designated to be device intensive, and they are meant to ensure that device costs are accounted for in Medicare rates for device-intensive procedures.
