In Billing
May 14th, 2018
Newly-released proposed rules provide a preliminary view of the fiscal year (FY) 2019 payment and policy updates to the Medicare program for hospices, inpatient psychiatric facilities, skilled nursing facilities, and inpatient rehabilitation facilities. The Centers for Medicare & Medicaid Services (CMS) released the four proposed rules on May 8. Hospice Update and Reporting Requirements This pr...
In Billing
May 3rd, 2018
Advocates are seeking to convince the Centers for Medicare & Medicaid Services (CMS) to pay for outpatient care of patients receiving 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery. The new code for 2018 was assigned a fee status of “inpatient only.” This is inconsistent with the current state of practice. Even though the complexity of ...
In Coding
Mar 16th, 2018
Medicare Part A claims that include ICD-10-CM diagnosis code D68.32 Hemorrhagic disorder due to extrinsic circulating anticoagulants will be denied after June 30, 2018, when the code is terminated. Per the Inpatient Hospital Billing Manual, Chapter 3, Section 20.7.3, Payment for Blood Clotting Factor Administered to Hemophilia Inpatients, effective July 1, 2018, payment may be made ...
In CMS
Jan 12th, 2018
The Centers for Medicare & Medicaid Services (CMS) announced on Jan. 9 the launch of their Innovation Center’s Bundled Payments for Care Improvement Advanced (BPCI Advanced) payment model. It’s voluntary and can earn providers payment if all costs for a patient’s episode of care are “under a spending target that factors in quality.” This differs ...
In Billing
Dec 13th, 2017
In case you were unaware of proper billing of services for Medicare patients in a covered Part A inpatient stay, here is a refresher. Medicare will not pay acute-care hospitals for outpatient services provided to patients in a covered Part A inpatient stay at another facility. This includes Medicare patients who are inpatients of long-term ...