Q: We have received some denials of services due to “illegible” or missing authentications and documentation. We still have some handwritten documentation that gets scanned into our electronic health record. Sometimes the physician’s office staff has highlighted where they want the physician to sign, but when we scan it, it is obliterated in the scan.
Where can we find the new Medicare Physician Fee Schedule (MPFS) rate for outpatient prospective payment system (OPPS), non-excepted departments? It didn’t seem to be clearly located on the MPFS final rule relative value units (RVU) file. Are we supposed to assume an exact 50% reduction of the OPPS rate?
What do we do when families want their loved one admitted as a hospital inpatient so he or she can qualify for a transfer to a skilled nursing facility?
Q: We have seen a decrease in payment for our CT scans this year. It is only affecting the scans that we report with modifier –CT, so it isn’t all of them, but it is enough that our CFO has asked about it.
In a provider-based department, when an injection is provided by a registered nurse, is the admin fee billed on the hospital’s UB claim form with the drug or under global billed on the 1500?
Q: The new conscious moderate sedation codes (99152-99157) have been assigned status indicator N (no additional payment, payment included in line items with APCs for incidental service) indicators. Please clarify if they are actually bundled into the APC payment.
If we have a building that is across the parking lot from the main building of the hospital and connected with a hallway, is that considered on-campus?
What is the organization’s responsibility with regard to the Medicare Outpatient Observation Notice (MOON) if a patient starts treatment as an outpatient but then is moved to inpatient status? Does the hospital still need to issue the MOON?
