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?
Q: Our coding department was told there were changes made for fiscal year (FY) 2020 when it comes to reporting healed/healing pressure ulcers and pressure-induced deep tissue damage. Can you explain any recent updates?
The Transparency in Coverage Proposed Rule comment period has been extended from January 14 to January 29, CMS announced. The proposed rule would require insurers to provide personalized price estimates and publish negotiated in-network rates and historical payment information.
