CMS - Make Your Revenue Smarter - Page 9

OPPS and ASC Final Rule for CY 2014

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This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2014 to implement applicable statutory requirements and changes arising from continuing experience with these systems.  In this final rule with comment period, are changes to the amounts and factors used to […]

The 2-Midnight Rule FAQs

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CMS has provided an FAQ document to address concerns regarding the 2 Midnight Inpatient Admission Guidance which begins October 1, 2013. Click to read the document on the CMS site. Q: Will CMS direct the Medicare review contractors to apply the 2-midnight presumption-that is, contractors should not select inpatient claims for review if the inpatient […]

Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal

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This interim final rule with comment period specifies the process and timeline for expanding CMS’ existing Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act). The interim final rule specifies a timeline for developing a multifactor authentication […]

IPPS Final Rule FY2014

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According to CMS the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals is being revised.  Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable […]

IRF PPS Final Rule FY2014

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This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2014 (for discharges occurring on or after October 1, 2013 and on or before September 30, 2014) as required by the statute. This final rule also revised the list of diagnosis codes that may be counted toward […]

Coding Mammography: Screening vs Diagnostic

SNF PPS and Consolidated Billing 2014 Final Rule

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This final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2014. In addition, it revises and rebases the SNF market basket, revises and updates the labor related share, and makes certain technical and conforming revisions in the regulations text. This final rule also […]

OPPS Proposed Rule 2014

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Medicare and Medicaid Programs:  Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organizations; Quality Improvement Organizations; Electronic Health Records (EHR) Incentive Program; Provider Reimbursement Determinations and Appeals This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) […]

Screening and Diagnostic Mammography

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CMS Guidance for documentation, coding and billing of mammography dated August, 2012. This article is from the Medicare Learning Network.