This week’s Medicare updates include the October 2016 Integrated Outpatient Code Editor specifications version 17.3; the Medicare Fee for Service (FFS) Recovery Audit program third quarter summary newsletter; and more!
CMS’ introduction of CMS-1455-R in March 2013 allowed hospitals to ignore the one-year timely filing deadline and rebill admissions that were denied by an auditor, even many years after the date of service. Fast forward to October 29, 2015, when the OIG released a policy stating that hospitals may waive the cost of self-administered medications to Medicare beneficiaries without concern about inducement or kickback accusations if the hospital develops a policy and applies it uniformly.
CMS’ proposed changes to implement Section 603 of the Bipartisan Budget Act of 2015 and reshape payments for off-campus, provider-based departments represent the most significant changes in the current year 2017 OPPS proposed rule.
What is the consequence if we miss giving a patient who meets the Medicare Outpatient Observation Notice criteria the notice? Has there been an update if the observation hours will need a modifier or the claim a value or condition code to show that the notice was given?
