Avoid misconceptions and clarify guidelines to make end-of-life services less intimidating. Hospice is a Medicare Part A benefit most often provided to terminally-ill patients who wish to remain in their homes. Medicare guidelines for hospice are detailed and can be arduous, however, making billing and reimbursement tricky. An overview of the guidelines and clarification of ...
In CMS
Apr 25th, 2018
A proposed rule issued April 24 provides an advance look at pending updates to Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) for fiscal year 2019. Proposed changes that make it into the final rule, usually released in August, will apply to approximately 3,330 acute ...
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 Audit
Jan 26th, 2018
The Centers for Medicare & Medicaid Services (CMS) measures the fee-for-service (FFS) improper payment rate through the Comprehensive Error Rate Testing (CERT) program. According to a 2017 CERT report, CMS had a 90.5 percent proper payment rate and a 9.5 percent improper payment rate for all claims submitted July 1, 2015, to June 30, 2016. ...
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 ...