On February 2, CMS Revised its Medicare Outpatient Observation Notice (MOON) instructions in MLN Matters 9935, but the document provided little new information, primarily reiterating much of what was already said in the 2017 IPPS final rule.
“CMS went into great detail on delivery of the MOON when the patient is not competent, but completely ignored providing details on the amount of specificity needed in completing the box specifying ‘the reason the patient is outpatient,’ ” says Ronald Hirsch, MD, FACP, CHCQM, vice president of the Regulations and Education Group at R1 Physician Advisory Services in Chicago. “This was one of the least helpful publications I have seen from CMS.”
For case management professionals, keeping up with the MOON revisions has been a challenge.
This week's note from the instructor discusses implementation of the Medicare Outpatient Observation Notice (MOON) and the implementation deadline, which is just a week away.
Coders prepared for 2017 with numerous changes to the Official Coding Guidelines for the ICD-10-CM and the addition of many new codes. Quietly waiting in the wings was the updated CPT® Manual for 2017 with its changes waiting to be discovered.
HCCs are the basis for risk adjustments for reimbursement models like Medicare Advantage, accountable care organizations (ACO), and other value-based purchasing measures such as Medicare Spending Per Beneficiary. Poor understanding and application of HCCs mean that a hospital’s patients may be much sicker in reality than they appear to be on paper. And that will hit reimbursement hard.
This week’s Medicare updates include a revision to State Operations Manual Appendix PP; ICD-10 Coding Revisions to NCDs, clarification of payment policy changes for Negative Pressure Wound Therapy using a disposable device and the outlier payment methodology for home health services; and more!
