News & Analysis

April 19, 2016
Medicare Web

Q: What elements must be included for inpatient certification?

April 15, 2016
Medicare Web

Q: What are some questions case managers can ask during the screening process?

April 13, 2016
Medicare Insider

There are two newly approved Recovery Auditor issues.

April 13, 2016
Medicare Web

Q: We have started using what our physicians call “high-frequency” neurostimulators. I know there are two HCPCS codes for reporting these to Medicare, but how do we know what is high frequency and what is not?

April 13, 2016
Medicare Insider

On March 31, CMS released special edition MLN Matters article SE1607 regarding new enforcement editing requirements for the Medicare Benefit Policy Manual (Internet-Only Manual 100-02), Chapter 6, section 70.3, which describes coverage and billing of Partial Hospitalization Program (PHP) services. This guidance is likely due to the significant problems with PHP service claims and coding highlighted in the 2016 proposed and final OPPS rules. This guidance is effective for PHP services furnished on or after July 1.

April 12, 2016
Medicare Insider

This week’s updates include a transmittal regarding completing and processing Form CMS-1500 Data Set; a transmittal from Provider Reimbursement Manual, Part 1–Chapter 31 on Organ Acquisition Payment Policy; and more!

Pages