Modifier -PD (diagnostic or related nondiagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within three days or one day) is now included in the I/OCE, according to January updates detailed in Transmittal 2370.
As technology evolves, providers can perform more procedures at the patient's bedside than they ever could in the past. Previously, they could only perform these procedures in another department of the hospital, and they had to charge separately for them.
Our coding experts answer your questions about physician supervision for chemotherapy, billing injectable drugs, Addendum B and coverage, new transitional care management codes, and stent placement with other procedures.
Q We're struggling with nursing documentation of stop times for IV infusions (e.g., piggybacks and hydration). The nurses also inconsistently document a patient's return to the unit from diagnostics. We know that CMS now allows us to use average times for common services, and we're interested in considering this approach at my organization. Can you share additional specifics?
CMS issues certain quarterly updates relating to hospital outpatient services.These updates are primarily issued in the form of two recurring update notification transmittals (RUN).The first of these is a quarterly update to the IOCE Specifications. The second is a quarterly update to the Outpatient Prospective Payment System (OPPS). Because the most significant outpatient hospital changes become effective as of the beginning of each calendar year, the January updates are particularly important.Click the link above for more information and an in-depth analysis.
On the heels of the 49th anniversary of the signing of Medicare and Medicaid into law, the Centers for Medicare & Medicaid Services (CMS) projected today that the average premium for a basic Medicare Part D prescription drug plan in 2015 will increase by about $1, to an estimated $32 per month, continuing its historically low growth rate.
In the OPPS proposed rule, CMS had proposed to do away with the device to procedure and procedure to device edits. While this may seem like a provider friendly change, in fact, these edits have ensured that all costs, including the costs of all devices used, are billed by providers. This in turn ensures they are taken into account in rate setting, because CMS uses providers’ billed charges as a proxy for cost in setting future rates. Click the link above for more information and an in-depth analysis.
