In July 2013, Medicare Administrative Contractors (MACs) began to recover overpayments on Annual Wellness Visit (AWV) claims with dates of service on and after January 1, 2011 that were processed by Medicare on and after April 4, 2011 through March 31, 2013 (see MLN Matters® Article #8153). It was subsequently determined that both the professional and technical components of Method II critical access hospital (CAH) claims had been identified as overpayments and recouped in error. Method II CAHs are entitled to payment for the professional components of these claims.
Last week, CMS released MLN Matters article MM8572 with billing instructions for laboratory services paid under either OPPS or the Clinical Laboratory Fee Schedule (CLFS). Prior to this guidance, I had received several questions from clients and past students regarding rural sole community hospital (SCH) add-on payments for lab services. Click the link above for more information and an in-depth analysis.
In the Medicare Claims Processing Transmittal 2903, April 2014 Update of the Hospital Outpatient Prospective Payment System (OPPS), CMS discusses the current policy regarding billing for certain devices that are received by facilities at no cost, full credit, or partial credit.
There has been some confusion surrounding a possible Recovery Auditor-related provision in the American Taxpayer Relief Act of 2012, also known as the fiscal cliff deal.
This week’s note is about coding, billing, and payment for skin substitute products. Click the link above for more information and an in-depth analysis.
