On February 2, CMS Revised its Medicare Outpatient Observation Notice (MOON) instructions in MLN Matters 9935, but the document provided little new information, primarily reiterating much of what was already said in the 2017 IPPS final rule.
“CMS went into great detail on delivery of the MOON when the patient is not competent, but completely ignored providing details on the amount of specificity needed in completing the box specifying ‘the reason the patient is outpatient,’ ” says Ronald Hirsch, MD, FACP, CHCQM, vice president of the Regulations and Education Group at R1 Physician Advisory Services in Chicago. “This was one of the least helpful publications I have seen from CMS.”
For case management professionals, keeping up with the MOON revisions has been a challenge.
Ever since Pat became a nurse case manager three years ago, both family and friends have reached out to her for healthcare advice. She really doesn’t mind and almost expects it, especially since healthcare can be complex and challenging. By sharing her knowledge as a case manager, Pat can often help people navigate healthcare complexities.
Ever since Pat became a nurse case manager three years ago, both family and friends have reached out to her for healthcare advice. She really doesn’t mind and almost expects it, especially since healthcare can be complex and challenging. By sharing her knowledge as a case manager, Pat can often help people navigate healthcare complexities.
Discharge planning, which is integral to providing continuity of care, is a dynamic process. The steps of discharge planning sometimes occur in order, they sometimes overlap, and they sometimes move back and forth.
As hospitals get ready to start notifying patients about their status under the requirements of the NOTICE Act using the MOON form, many still have questions about the process and the form itself. The NOTICE Act requires hospitals to provide a verbal and written notice (using the MOON form) of outpatient status to any patient who has been in observation for more than 24 hours. The hospital must provide notice to the patient within 36 hours of the start of the service, or at the time of discharge or inpatient admission. “The notice must be provided no later than 36 hours after observation services are initiated or, if sooner, upon release,” according to CMS.
Looking to get an ACM™ certification? In December, the American Case Management Association (ACMA) and National Board for Case Management (NBCM) announced a change to the exam eligibility requirements that may be of interest to those looking to earn ACM certification. The NBCM now allows applicants with at least one year of full-time supervised work experience to sit for the ACM-RN (Registered Nurse) and ACM-SW (Social Work) exams. Prior to this change, candidates had to have at least two years of case management experience before they could take either exam.
This week’s Medicare updates include Medicare Outpatient Observation Notice (MOON) instructions, ICD-10 coding revisions to NCDs, a new “K” code for continuous positive airway pressure device bundle, and more!
The March 8 Medicare Outpatient Observation Notice implementation deadline is quickly approaching, which means organizations must act now to ensure that their staff members are ready accurately and completely to fill out and deliver the form. There were some changes from the proposed version of the form CMS first released to the final version it ultimately approved December 7, 2016.
