Medical Necessity Reviews Approved for Some New DRGs DCS Healthcare, the Recovery Audit Contractor (RAC) for CMS Region A, posted approvals on Tuesday morning, December 7, for 21 new CMS approved issues for RAC review, including 110 new DRG Validations, plus medical necessity review for Renal and Urinary Tract Disorders, which would include at least […]
Procedures That Will be Paid Only as Inpatient for CY2011 This is a zip file for download. CPT® license agreement required. 2011 OPPS Final Addenda [ZIP, 1.54MB](The 2011 Inpatient Only List is here as Addendum E.) Additional information is found in Part 4 of the Medicare Claims Processing Manual beginning on page 126.
Medicare OPPS Final Rule for FY2011 Published The final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health […]