Baylor Scott & White-College Station didn't properly bill Medicare for supplemental outlier payments, according to a September Office of Inspector General (OIG) report. Reviewed claims contained errors due to overcharging and inaccurate coding, resulting in $189,276 in overpayments, said the report.
CMS recently released the FY 2021 IPPS final rule, which increased hospital payment rates, created new MS-DRGs, and finalized the FY 2021 ICD-10-CM/PCS code sets and CC/MCC designations to be implemented October 1.
The American Medical Association (AMA) on September 8 published two new CPT codes for novel coronavirus (COVID-19)-related services, including one that accounts for additional supplies and clinical staff time used to mitigate the spread of the virus.
CMS recently released guidance stating that for inpatient novel coronavirus (COVID-19) claims, a positive viral test result is now required in order to be eligible for the 20% increase in the MS-DRG weighting factor. This became effective for all admissions on or after September 1.
The 2021 MPFS proposed rule, released August 3, introduces new policies under the Quality Payment Program (QPP) including plans to delay implementation of the Merit-based Incentive Payment System Value Payment (MVP) model and introduce 108 new quality measures.
On July 30 CMS announced the addition of 12 new ICD-10-PCS codes to describe the Introduction or Transfusion of therapeutics for treating patients with COVID-19. These new codes became effective August 1.
Medicare Recovery Audit Contractors (RAC) reported that several outpatient claims did not meet medical necessity requirements for hyperbaric oxygen (HBO) therapy for diabetic wounds of the lower extremities, according to the July 2020 Medicare Quarterly Provider Compliance Newsletter .
According to a recent audit by the Department of Health and Human Services’ Office of Inspector General (OIG), Ohio State University Hospital received millions in overpayments during an audit period due to errors in coding, MS-DRG assignment, and billing.
The American Medical Association (AMA) recently announced a new CPT® code for reporting antigen testing performed on patients suspected of being infected with the novel coronavirus (COVID-19). The new code is intended to improve reporting of antigen tests using an immunofluorescent or immunochromatographic technique for detection of COVID-19.
The ICD-10-CM Coordination and Maintenance Committee recently released the fiscal year (FY) 2021 ICD-10-CM code set, which includes 490 new, 58 deleted, and 47 revised ICD-10-CM codes. Along with updates to the Tabular index, these changes include new codes for reporting chronic kidney disease and body mass index.
CMS’ recently released the fiscal year (FY) 2021 IPPS proposed rule which included proposals for the creation and revision of various MS-DRGs. In particular, CMS proposed the creation of a new MS-DRG for cases involving chimeric antigen receptor T-cell (CAR-T) therapies.
CMS recently published details on prior authorization requirements, established by the 2020 OPPS final rule, for select hospital outpatient department (HOPD) services, scheduled to go into effect July 1.
CMS recently released the fiscal year (FY) 2021 ICD-10-PCS code set and ICD-10-PCS Official Guidelines for Coding and Reporting . The ICD-10-PCS code update includes new codes for Fragmentation and Drainage, while the guidelines update includes new and revised guidelines for certain root operations, approach values, and device combinations.
CMS issued the proposed lists of new, revised, and invalidated ICD-10-CM codes May 11 in conjunction with the fiscal year (FY) 2021 Inpatient Prospective Payment System proposed rule. The update will be significantly larger than the FY 2020 ICD-10-CM update if all the proposed changes are finalized.