This week's note examines a new Special Edition MLN Matters article, SE18002, and its impact on billing processes for OPPS providers with multiple service locations.
Q. My understanding is that HIPAA doesn’t mandate use of a specific security standard. Are we required to keep documentation explaining why we chose a particular security standard? I’ve also been told that we are required to encrypt data according to National Institute of Standards and Technology standards. Is this spelled out in the regulations?
Many hospitals find that their Patient Safety Indicator (PSI) ratios remain high despite doing a spectacular job of addressing these events and exclusions. That may be because they fail to realize that the Agency for Healthcare Research and Quality has a risk-adjustment methodology that predicts each of these PSIs and is dependent upon the documentation and coding of PSI-sensitive risk factors.
This week’s Medicare updates include several corrections to transmittals issued regarding April 2018 payment system updates, four new resources for those participating in the Quality Payment Program via an alternative payment model, an OIG review of outpatient physical therapy billing, and more!
CMS instructed Medicare Administrative Contractors (MAC) to review previously denied 2018 outpatient therapy claims reported with modifier -KX. However, because MACs might not automatically review all denied therapy claims, providers will need to initiate the process.
