In Billing
Jan 31st, 2019
The Centers for Medicare & Medicaid Services (CMS) revised its Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNF ABN), last spring, and at the same time discontinued five Skilled Nursing Facility (SNF) Denial Letters. Here are the details, in case you missed them. An Updated Advanced Beneficiary Notice MLN Matters MM10567 Revised, effective April ...
In CMS
Jan 25th, 2019
There are big changes on the horizon for the Medicare Part D prescription drug model, and they’re going to affect medical coders. The current reimbursement system and payment model for Part D creates incentives for plans to push patients to the “catastrophic phase.” Once the patient reaches this “donut hole,” Medicare is responsible for 80 ...
This open and expandable procedural code set is nothing to be intimidated by. When outpatient coders talk about ICD-10, they typically mean the ICD-10-CM (diagnosis) code set. But there’s another ICD-10 code set: ICD-10-PCS. If you’re unfamiliar, here’s an introduction. PCS Describes Inpatient Procedures The ICD-10-PCS code set is used to code inpatient procedures; PCS ...
Adhere to the Medicare requirements and bundling rules for SNF coverage payment. If you don’t work in a skilled nursing facility (SNF), you may not understand how SNF consolidated billing (CB) affects you. The way you answer the following two questions may help you to see the connection: Have you ever had a Medicare patient ...
In CMS
Dec 5th, 2018
U.S. hospitals that are putting quality over quantity will fare well next year for their efforts. Out of  approximately 2,800 hospitals across the country, more than 1,550 will see an increase in their 2019 Medicare payments. For the rest? Well, the news isn’t so good. Where Does the Money Come From? The Centers for Medicare ...