Q: For the purposes of determining a Medicare overpayment, should claims that we are uncertain whether they were appropriate be included? Is this defined under the False Claims Act (FCA)?
CMS’ Fourth COVID-19 Interim Final Rule with Comment Period includes additional payment for new COVID-19 treatments, price transparency requirements for COVID-19 diagnostic tests, and coverage for potential vaccines among other provisions.
The full U.S Court of Appeals declined to reconsider two recent decisions that upheld CMS’ cuts to reimbursement for certain off-campus provider-based department (PBD) visits and drugs acquired under the 340B program, the American Hospital Association (AHA) announced October 19.
Physician and non-physician practitioners may benefit from reviewing bundling rules for emergency department visit services billed on the same date as critical care, according to the October 2020 Medicare Quarterly Compliance Newsletter.
Q: Starting January 1, 2021, CMS will be lowering reimbursement for high throughput novel coronavirus (COVID-19) diagnostic tests from $100 to $75. I understand that if certain requirements are met labs will be eligible to bill for a $25 add on code. How can we meet the requirements for the add on code?
CMS will reduce payments to laboratories that take longer than two days to complete high-throughput COVID-19 diagnostic tests effective January 1, 2021, according to an October 15 press release.
Outpatient coders should be familiar with CPT reporting for knee surgeries based on information in the operative note. This article reviews the anatomy of the knee joint and CPT coding for arthroscopic and reconstructive procedures used to visualize and treat common knee conditions.
