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.
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?
Four years after they were proposed, CMS has finalized a series of discharge planning changes that went into effect on October 29. The final rule, called Revisions to Discharge Planning Requirements [CMS-3317-F], imposes a number of new requirements—ranging from how to notify patients about their choice in postacute providers to prioritizing patient preferences when developing discharge plans and treatment goals.
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.
