This week’s updates include: Claims processing Medicare Secondary Payer (MSP) policy and procedures regarding ongoing responsibility for medicals (ORM); Maintenance and update of the temporary hook created to hold OPPS claims that include certain drug HCPCS codes; and more!
During several recent Medicare Boot Camp—Hospital Version® classes, I noticed some confusion about the four parts of Medicare. With respect to each part, there appeared to be confusion about the authority or entity responsible for determining the scope of covered services, beneficiary cost sharing, adjudication of claims, and payment for covered services. Based upon this apparent need for clarification, this is the first of three notes that will focus on the four parts of Medicare: Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D.
This week’s updates include the SNF Consolidated Billing update and a special edition MLN Matters article regarding claims submission alternatives for providers who have difficulties submitting ICD-10 claims.
While implementation of the long awaited and long overdue ICD-10 coding system is just around the corner, some questions still remain regarding “split billing” based on the October 1, 2015, date of service. Lately, I have been asked questions by billing staff from both PPS and critical access hospitals (CAH) so this may be a good time to clarify how and when to split bill.
Update to hospice payment rates, cap, wage index and Pricer for FY 2016; State Operations Manual (SOM), Section 2185- HHAs, change of address to a MAC within 90 days; and more!
