Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?
Medicare increased payments for patients diagnosed with the novel coronavirus (COVID-19). MLN Matters SE20015, implements provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act for hospitals paid under the Inpatient Prospective Payment System (IPPS), long-term care hospitals (LTCH) PPS, and inpatient rehabilitation facilities (IRF) PPS.
CMS on April 14 released a ruling that nearly doubles Medicare Part B payment for rapid-result COVID-19 laboratory tests from about $51 per test to $100 per test. The payment increase applies to tests performed on or after March 18 and remains in effect until the end of the public health emergency.
Under both the 1135 waiver and the Coronavirus Preparedness and Response Supplemental Appropriations Act, CMS is increasing access to Medicare’s telehealth services to allow beneficiaries to receive professional healthcare services without having to travel to a healthcare facility.
Coders can raise the flag for the risk management department by signaling unexpected patient care occurrences, such as a nicked organ during surgery. Use this sample occurrence report form as a template for your organization.
Clinical validation reviews and queries ensure that the documented diagnoses and clinical indicators hold up to inspection. Use these strategies to head off clinical validation reviews and improve documentation.
The CDC estimates there are an estimated 35,900 deaths a year from antibiotic-resistant infections. Learn how to improve coding and documentation of these infections.
To code for spinal excisions and decompression procedures, coders must break down provider documentation to determine the surgical approach utilized and surgical specialists involved, and in some cases, visualize how the procedure was performed across multiple levels of the spinal column.
Q: Can a hospital bill for a nutritionist and a dietitian deliver diabetes self-management training (DSMT) via telehealth on a UB claim? Nutritionists and dietitians are on the list of distant site practitioners, although registered nurses are not.
