This week’s Medicare updates include the Outpatient Prospective Payment System final rule, the Medicare Physician Fee Schedule final rule, a proposed decision memo on genetic testing for cancer, and more!
Q: How should we handle denied claims when the payer refuses payment under the billed status? Do we need to document that the status was changed only because the payer did not agree to any other options?
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.
The fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, released shortly after the FY 2020 ICD-10-CM code release, provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Coders should take time to review these changes that were implemented October 1.
The 2020 IPPS final rule is out, and CMS has opted not to allow organizations to code homelessness as a complication or comorbidity (CC) under ICD-10-CM code Z59.0.
