This week’s updates include changes to the laboratory NCD edit software for January 2016, medical record signature requirements, and more! Click here to read all of this week’s updates.
This week’s updates include the October 2015 update of the ASC payment system; postpayment review requirements; and more! Click here to read all of this week’s updates.
This week’s updates include: Claims processing Medicare Secondary Payer (MSP) policy and procedures regarding ongoing responsibility for medicals (ORM); Maintenance and update of the temporary hook created to hold OPPS claims that include certain drug HCPCS codes; and more!
Heart disease is the most common cause of death for both men and women in the U.S., according to the Centers for Disease Control and Prevention (CDC). The most common type is coronary artery disease (CAD), which can lead to heart attacks, heart failure, angina, and arrhythmias, according to the CDC.
During several recent Medicare Boot Camp—Hospital Version® classes, I noticed some confusion about the four parts of Medicare. With respect to each part, there appeared to be confusion about the authority or entity responsible for determining the scope of covered services, beneficiary cost sharing, adjudication of claims, and payment for covered services. Based upon this apparent need for clarification, this is the first of three notes that will focus on the four parts of Medicare: Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D.
Last week was a quiet week for CMS other than the release of the FY 2016 IPPS final rule on August 17 in the Federal Register. I thought I would take this opportunity to look at a billing issue about which I have recently been asked several questions. The questions generally revolve around how a hospital can bill for ambulance services when an inpatient leaves the facility for a procedure at another facility with the intention to return the same day. Unfortunately, since a hospital will trigger an edit that prevents the ambulance revenue code from being reported on the inpatient claim, it is assumed that the hospital must write off the transportation service. In fact, just the opposite is true based on CMS guidance.
One of the biggest challenges to the provider community, including hospitals and critical access hospitals (CAH), is keeping up to date with current regulatory requirements, particularly when it comes to rules on coverage, coding, billing, and payment for services provided to beneficiaries under federal healthcare programs, including Medicare and Medicaid. For those of you who have taken one of our hospital or CAH Medicare Boot Camps, you probably remember discussing this early during the week, when we identified the major official sources of authority on Medicare rules, as well as some tips about how to efficiently keep yourselves up to date.
