In CMS
Feb 21st, 2019
No doubt your provider’s office or group practice has sent patients via ambulance to the hospital. Now, Medicare wants ambulances to bring patients to you. This a 2020 change for medical coding of transports and for providers. And it may affect evaluation and management (E/M) coding in providers’ offices. Ambulances Redirected The Centers for Medicare ...
In Billing
Feb 23rd, 2018
Several new Medicare Learning Network (MLN) fact sheets offer tips on provider compliance for certain items that regularly appear on the Office of Inspector General Work Plan due to a high level of improperly paid claims. Here’s a quick synopsis. Hospital Beds and Accessories Physicians and other practitioners who write requisitions or orders for hospital beds ...
In Billing
Jan 29th, 2018
Continuing the effort to prevent and combat healthcare fraud, waste, and abuse where it occurs most, the Centers for Medicare & Medicaid Services (CMS) has extended the statewide temporary moratoria on the enrollment of new Medicare Part B, Medicaid, and Children’s Health Insurance Program (CHIP) non-emergency ground ambulance providers and suppliers and home health agencies, sub-units, and ...
In Billing
Feb 12th, 2015
Ensuring coverage of ambulance services for your end-stage renal dialysis (ESRD) patients requires diligence. Dialysis facility ambulance transports often do no meet medical necessity criteria, as defined by the Centers for Medicare & Medicaid Services (CMS). The CMS IOM Pub. 100-02, Medicare Benefit Policy Manual, Chapter 10, Section 10.2.1, “Necessity for the Service” states: Medical ...
Expanded oversight requires action on all fronts. By Michael D. Miscoe, JD, CPC, CASCC, CUC, CCPC, CPCO A key purpose of the Office of Inspector General’s (OIG) annual Work Plan is to report on new and ongoing areas in healthcare thought to be susceptible to fraud, waste, and abuse. This year, OIG will continue to ...