CMS proposes aligning its conditional packaging modifiers and deleting a much-maligned modifier for separately payable laboratory tests in the 2017 OPPS proposed rule, released July 6.
CMS recently released its seventh maintenance update for National Coverage Determinations to incorporate ICD-10 and other coding updates, which may require providers to contact Medicare Administrative Contractors regarding previously submitted claims.
The new modifier -PO (services, procedures, and/or surgeries furnished at off-campus provider-based outpatient departments [PBD]) and the alternative payment provisions under the Bipartisan Budget Act Section 603 are both related to off-campus PBDs but define "off-campus PBD" slightly differently.
The government may finally have to comply with its congressionally mandated deadlines for reviewing claims at the Administrative Law Judge level after a federal appeals court this week reversed a lower court’s dismissal of a lawsuit brought by hospitals.
Developing a strong denial management program may be one of the best ways to minimize the productivity and financial losses anticipated with the transition to ICD-10. By determining a baseline for denials and proactively identifying denial trends, organizations can efficiently resolve issues and reduce costs. An effective denial management program will help organizations to track, trend, resolve, and ultimately prevent denials.
This week CMS released guidance on the new Place of Service (POS) code for off-campus provider-based facilities, the 2-Midnight Rule, and appeals of claims denied by post-payment review contractors. Each item is short, but provides information on topics important to providers and physicians.
