If your organization is like many others, you may still have some unanswered questions about the 2-midnight rule. To get organizations up to speed, Medicare Administrative Contractor (MAC) teams are now providing education sessions nationwide. These sessions are designed to give organizations an overview of what to expect and how to comply.
With new regulatory pressures and a changing political landscape, the world of case management is changing. One trend you may notice is an increase in the number of outside organizations, such as physician's offices, insurance companies, and postacute facilities that are hiring their own case managers to help manage patients. These individuals are often referred to as liaisons.
Hospital outpatient therapeutic services, such as ED or clinic visits, that are paid under the OPPS or to critical access hospitals (CAH) on a cost basis must be furnished "incident to" a physician's service to be covered.
CMS made relatively few changes in the April quarterly I/OCE update, introducing four new APCs, deleting one, and reclassifying several skin substitute codes.
