Oceanside Medical Group, a clinic providing mental health services in Santa Monica, California, is disputing an Office of Inspector General (OIG) report that estimated the group received $2.6 million in overpayments for psychotherapy services by failing to comply with Medicare billing and documentation requirements.
While the calendar year 2020 OPPS proposed rule is shorter than in prior years (819 pages for the display version), the proposed policies therein pack a punch and may be thought of as a new day dawning for the future of hospital services.
The American Medical Association recently released the 2020 CPT code set, adding 248 new codes including many for online E/M services and drug-delivery device implantations, set to go into effect January 1.
Q: How should we handle canceled inpatient-only procedures? Are these are still coded to the full intended procedure under OPPS and modified with a -73 or -74 modifier? Most of these cases result in changed orders to outpatient due to the patient being discharged the same day. Can the original inpatient order be used?
The October 2019 OPPS quarterly update reassigned certain injections from non-payable to separately payable. CMS also revised the status indicators for several recently approved advanced diagnostic laboratory tests (ADLT).
Perhaps the most momentous Quality Payment Program (QPP) news in the proposed 2020 Medicare physician fee schedule is the Pathways (MVP) version of the Merit-based Incentive Payment System (MIPS) — but that’s not happening until 2021.
As Medicare Advantage makes strides to becoming the new norm, organizations need to establish new processes, educate staff, and advocate for patients. Learn how your organization can keep pace with change before it’s too late to catch up.
The 2020 IPPS final rule made major changes to the hospital wage index and new technology payments. Brush up on the details to ensure your organization is ready.
The Revenue Integrity Symposium is a conference that truly speaks to the contemporary and emerging issues that revenue integrity professionals grapple with.
