A new notification requirement is coming next summer. Under the law, the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, which was signed by President Barack Obama on August 6, any patient in observation who has been in the hospital for more than 24 hours must be clearly told?verbally and in writing?of his or her outpatient status. Hospital officials have to deliver this notification no more than 36 hours after the patient's outpatient treatments begin.
Providers know the drill for addressing and operationalizing CMS' annual IPPS and OPPS updates, along with the usual ICD-9-CM and CPT® coding changes. The industry has become used to CMS' timetable for releasing inpatient and outpatient proposed and final rules and knows that it has to be ready to go live with coding, billing, and operational changes October 1 and January 1, respectively.
After several delays, ICD-10 implementation is finally upon us. The healthcare industry has spent years planning, training, and testing?and now the moment we have all been waiting for has arrived. But don't breathe a sigh of relief just yet.
After years of delays, industry and legislative pushback, and millions spent on technology upgrades and education, ICD-10 is finally here. Even though the fundamental process of coding and billing claims has not changed, providers will still need to pay close attention to their processes to keep the revenue cycle going and reduce denials.
Most short-term acute-care inpatient hospital stays covered under Medicare Part A are payable under the IPPS, based upon the MS-DRG to which that case is assigned. Each FY, CMS publishes a final rule setting out the IPPS changes for that FY. The IPPS changes for FY 2016 can be found in more detail in the source authorities cited at the end of this note.
This week’s updates include the beginning of Medicare Open Enrollment; January 2016 quarterly update for the DME, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP); and more!
