CMS released the fiscal year (FY) 2022 IPPS final rule on Monday, August 2, which finalizes its efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. Along with payment rate updates, the final rule also repealed the MS-DRG relative weight methodology and hospital cost-reporting requirement finalized in the 2021 IPPS final rule.
The fiscal year (FY) 2022 ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting, both effective October 1, were recently released by the Centers for Disease Control and Prevention and CMS, respectively.
Staten Island University Hospital overcharged Medicare an estimated $11.8 million for inpatient and outpatient services billed over a two-year period, according to a recent Office of Inspector General (OIG) report.
The Centers for Disease Control and Prevention recently released the fiscal year (FY) 2022 ICD-10-CM code set which includes 159 new, 20 revised, and 32 deleted ICD-10-CM codes. CMS also released the finalized ICD-10-PCS codes for FY 2022, which includes 191 new, 62 revised, and 107 deleted ICD-10-PCS codes. The code changes take effect October 1, 2021.
Medicare Recovery Auditors will review claims submitted by inpatient psychiatric facilities to ensure that billed services are medically reasonable and necessary, according to a recent Medicare Quarterly Provider Compliance Newsletter.
University of Michigan Health System overcharged Medicare an estimated $12.5k for polysomnography services submitted over a two-year period, according to a recent Office of Inspector General (OIG) report. Overpayments were due to insufficient documentation and CPT coding errors.
The Office of Inspector General (OIG) recently performed a compliance audit of specific diagnosis codes billed by Anthem Community Insurance Company Inc. to CMS and found that the company submitted unsupported diagnosis codes for 123 of the 203 enrollee-years.
CPT codes 63685 and 63688 for spinal neurostimulator procedures have been removed from the list of services that would require Medicare prior authorization when performed in a hospital outpatient department, CMS announced on May 13.
The Office of Inspector General (OIG) performed a provider compliance audit of the Virtua Our Lady of Lourdes Hospital and found that the hospital received overpayments of approximately $4.8 million between January 1, 2016 and December 31, 2017.
CMS’ recently released fiscal year (FY) 2022 IPPS proposed rule includes 153 proposed ICD-10-CM code additions, mainly affecting reporting for immune effector cell-associated neurotoxicity syndrome, gastric intestinal metaplasia, and poisonings by cannabis and synthetic cannabinoids.
A Humana health plan in Florida collected nearly $200 million in Medicare overpayments in 2015 by improperly coding for high-severity Hierarchical Condition Category conditions, according to a recent audit from the Office of Inspector General (OIG).
CMS recently added 24 audiology and speech-language pathology services to its list of telehealth services covered under Medicare during the COVID-19 public health emergency (PHE). These services include speech, hearing, and swallowing assessments, and cognitive interventions.
Physician and non-physician practitioners may benefit from reviewing documentation requirements and HCPCS Level II codes for knee orthoses, according to a recent Medicare Quarterly Compliance Newsletter .
The American Medical Association’s (AMA) CPT Editorial Panel at its February meeting approved technical corrections to the E/M coding guidelines for outpatient visits. The corrections were uploaded to the AMA website on March 9 and go into effect retroactively from January 1.
CMS recently added six codes to the list of services that may be reported with HCPCS modifier -CS (cost-sharing), which requires Medicare to cover beneficiary cost-sharing during office visits and other encounters for the duration of the COVID-19 public health emergency.