CMS released the fiscal year 2018 IPPS proposed rule in April, and with it came a bevy of new potential ICD-10-CM codes. The update includes a total of 406 proposed new, revised, and deleted codes to be implemented October 1, 2017.
The Substance Abuse and Mental Health Services Administration (SAMHSA) gave organizations and patients some relief from the stricter privacy rules protecting substance abuse and treatment information. But did SAMHSA really make the rule simpler, or will privacy and security officers find themselves grappling with a fresh set of complicated rules and exceptions?
Nancy is a manager of a hospital with a large indigent population. Nancy notes that immediately after the implementation of healthcare reform, many of her patients have obtained some form of health insurance, usually Medicaid. Often, the patients access Medicaid with the help of the hospital’s expert financial counselors. Recently, however, the number of uninsured patients in the community seems to be increasing. As a result, more uninsured patients are being admitted. Before healthcare reform, many uninsured people failed to seek timely, preventive healthcare. Therefore, they were quite sick by the time they came to a hospital. Nancy is now seeing a resurgence of uninsured indigent patients.
Q: We have started receiving rejections for claims with HCPCS code C1842 (retinal prosthesis, includes all internal and external components). We provide the service with the retinal implant and are confused why it's getting rejected.