Physicians may be angry at the increased documentation, coding, and billing workflow and compliance activities they must perform to be successful in new reimbursement models. However, to avoid accustations of fraud and upcoding, they must develop their own OIG-recommended compliance plan and be open to rigorous feedback and advice.
This week’s Medicare updates include the announcement of the Part A and Part B premiums and deductibles for 2018, clarification on new Conditions of Participation regarding home health agency subunits, a proposed decision memo on conditions of coverage for implantable cardioverter defibrillators, and more!
The overall monthly national healthcare spending rate modestly increased 4.3% from August 2016 to August 2017, with a notable increase in home health spending, according to a brief from Altarum’s Center for Sustainable Health Spending.
What are some examples of extenuating circumstances that could be modified with an -XU modifier (unusual nonoverlapping service) if none of the other -X modifiers are applicable?
Rush University Medical Center in Chicago did not comply with Medicare billing requirements for 57 inpatient and outpatient claims reviewed by the OIG, according to the OIG’s November report. This resulted in unlawful reimbursement for calendar years 2014 and 2015 with the medical center receiving $814,150 in overpayments, says the report.
