The April Integrated Outpatient Code Editor had a large volume of clarifications and changes to correct issues with processing claims related to new policies adopted in January. This article will explain when organizations can reprocess claims that were negatively affect by the edits.
Q: I have a question regarding which place of service (POS) code I should use for an orthopedic doctor who did a consultation on a patient that came through the ED. The patient has a spiral fracture of the humerus. The electronic record documents that the patient was admitted to the medical unit on January 31 but was a “boarder” in the ED until February 2, waiting on a room to be available. The orthopedic doctor saw the patient on February 1. The patient did finally receive a room assignment on February 2. In this scenario would I use POS 22 (outpatient hospital) or 23 (ED)? This patient has Medicare.
CMS released a series of special edition articles applicable to chiropractic services on March 16. Medicare has a very limited coverage benefit for chiropractic services. This article will explain when treatment is covered and how to properly document medical necessity.
This week’s updates include implementation of the award for Jurisdiction A DME MAC workload; April 2016 Integrated Outpatient Code Editor (I/OCE) Specifications Version 17.1; and more!
The healthcare industry got a five-year break from annual code updates for ICD codes as preparations for ICD-10 implementation took place, but the updates will be back this year and bigger than ever.
This week’s updates include July quarterly update to 2016 annual update of HCPCS codes used for SNF Consolidated Billing (CB) enforcement; updates to Pub. 100-04, Medicare Claims Processing Manual, Chapters 4 and 5 to correct remittance advice messages; and more!
CMS proposed a test this week for a new Medicare Part B prescription drug plan that would replace its previous policy of paying physicians and outpatient hospital departments the average sales price (ASP) plus 6%.
