In Billing
Jun 29th, 2012
Effective July 1, physician offices and other Part B entities wholly owned or operated by a hospital must append modifier PD Diagnostic or related nondiagnostic item or service provided in a wholly owned or operated entity to a patient who is later admitted as an inpatient within 3 days to codes for diagnostic or related non-diagnostic items or ...
In Audit
Jun 1st, 2012
The Centers for Medicare & Medicaid Services (CMS) has posted on its website the MLN Quarterly Provider Compliance Newsletter for April. The top billing errors for this month, detected by Comprehensive Error Rate Testing (CERT) and recovery auditors, all pertain to inpatient hospitals. Three-day Rule At the top of the list is a CERT finding ...
The new three-day payment rule may be part of the 2011 Inpatient Prospective Payment System (IPPS) final rule but outpatient coders are not immune. The new rule requires inpatient and outpatient coders to work together to avoid improper claims payment. Michelle A. Leppert, CPC-A, senior managing editor for justcoding.com talks with Jennifer Hume, CPC, CPMA, ...
In Billing
Aug 13th, 2010
Effective for services furnished on or after June 25, hospitals must include on a Medicare claim for a beneficiary’s inpatient stay the diagnoses, procedures, and charges for all preadmission outpatient diagnostic and nondiagnostic services that occur up to three days preceding the inpatient admission. Section 102 of the Preservation of Access to Care for Medicare ...