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 […]
Coding Mammography: Screening vs Diagnostic
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) […]
CMS Guidance for documentation, coding and billing of mammography dated August, 2012. This article is from the Medicare Learning Network.
The proposed rule updates hospital Part B inpatient billing policy consistent with the statute and payment regulations: When the Medicare review contractor denies a Part A claim because a hospital inpatient admission is not reasonable and necessary, Medicare would accept new, timely filed Part B inpatient claims and provide payment for all reasonable and […]
The Budget Control Act of 2011 requires, among other things, mandatory across-the-board reductions in Federal spending, also known as sequestration. The American Taxpayer Relief Act of 2012 postponed sequestration for 2 months. As required by law, President Obama issued a sequestration order on March 1, 2013. The Administration continues to urge Congress to take prompt […]
Critical Access Hospitals: Documentation for Quality Measures
Procedures That Will be Paid Only as Inpatient for CY2013 This is a zip file for download. CPT® license agreement required. CY2013 OPPS Addenda [ZIP, 2.1 MB] (The 2013 Inpatient Only List is here as Addendum E.)