This week’s updates include substantial revisions to QIO Manual for reviews involving potential administrative sanctions; Comprehensive Care for Joint Replacement Model (CJR) provider education; and more!
Despite industry pushback and several delays, ICD-10 implementation has, against all odds, gone relatively smoothly for the vast majority of providers, leading CMS to tout its success in a recent blog post from Andy Slavitt, CMS’ acting administrator.
An international task force with expertise in sepsis pathobiology, clinical trials, and epidemiology released updated definitions for sepsis and septic shock this week, which were last revised in 2001.
Q: We are having a heated internal discussion regarding reporting drug infusion charges when a multi-lumen catheter is being used. Nursing wants to charge for both lumens as if they were a separate line because they are hanging different medications and fluids through each one. When we tried this on a claim, the edits were either saying we needed to append a modifier for one of the initial hours of service or we hit the medically unlikely edit because of too many units. How is this supposed to be reported?
Recent national coverage determination transmittals could mean changes to coverage of certain preventive services. Referring providers, revenue cycle and integrity staff, and others dealing with coverage of these services should be aware of and make adjustments to their processes accordingly.
This week’s updates include Critical Access Hospital (CAH) Recertification Checklist for evaluation of compliance with the location and distance requirements; core quality measures collaborative release; and more!
CMS won’t release guidance on the payment impact of Section 603 of the Bipartisan Budget Act of 2015 until the 2017 OPPS proposed rule, but the American Hospital Association (AHA) has weighed in with a letter to Congress urging the government to reject further site-neutral payment policies.
Q: I have a follow-up question to last week’s answer about lab payments. We should receive payment for a lab-only claim because of the new Q4 status indicator. However, we noticed that sometimes we do and sometimes we don’t. The difference seems to be when we report a venipuncture and when we report the blood being drawn from a ventricular assist device (VAD). When the venipuncture is reported, we get paid for all line items. When the blood draw is from a VAD, we don’t get paid for the lab work. Is this correct?
