Identify, address, and reduce common compliance issues in your facility’s pharmacy department. By Erica Lindsay, PharmD, MBA, JD An effective compliance program identifies risks and operational deficiencies, while ensuring the entity conforms to the law. Compliance departments are responsible for many areas within the healthcare facility, including billing, lab, patient care, and pharmacy. Pharmacy...
Oct 30th, 2013
Medicare payers may require you to report discarded amounts of single-use drugs or biologicals as separate line items with modifier JW Drug or biological amount discarded/not administered to any patient appended. In every case, however, practitioners must document unused portions in the patient record. If a recent Office of Inspector (OIG) review is any indication, ...
The basics of ambulatory surgery center (ASC) coding and billing aren’t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what’s most important in the ASC setting. Definition of ASC To understand correct coding and billing for an ASC, you must first understand what an ...
In CMS
Mar 16th, 2012
The Centers for Medicare & Medicaid Services (CMS) has posted April 2012 changes to billing instructions for payment policies implemented in the hospital Outpatient Prospective Payment System (OPPS). The April 2012 updated Integrated Outpatient Code Editor (I/OCE) and OPPS Pricer will reflect the HCPCS Level II, ambulatory payment classification (APC), HCPCS modifier, and revenue code ...
In Billing
May 14th, 2010
Recent guidance issued by the Centers for Medicare & Medicaid Services (CMS) clarifies the appropriate use of modifier JW Discarded drug not administered when reporting unused units of drugs and biologicals for reimbursement. Failure to follow this guidance could result in excessive units billing. Medicare reimburses physicians, hospitals, and other providers or suppliers for the unused ...