Q: In my facility, we are supposed to send an email to our physician advisor (PA) and to administration if a query is not answered within a week. However, this policy doesn’t work well because administration does not do anything with that information, and the PA doesn’t have time to review unanswered queries. Do you have any suggestions concerning when to let a query go unanswered?
This week’s Medicare updates include a Multiple Procedure Payment Reduction on the Professional Component of certain diagnostic imaging procedures; a new condition code to use when hospice recertification is untimely and corrections to hospice processing problems; and more!
On July 7, CMS posted a fact sheet regarding a newly proposed Diabetes Prevention Program. This new benefit was proposed in the calendar year 2017 Medicare Physician Fee Schedule proposed rule.
I was under the impression that CMS said it would leave the billing for self-administered drugs to the OIG. However, we have not heard anything from the OIG. What if we are not billing for the medications?
Hospitals got a last-minute reprieve from the Medicare Outpatient Observation Notice (MOON) notification requirement, which was set to go into effect August 6. Citing the need for additional time to revise the standardized notification form that hospitals will need to use to notify patients about the financial implications of being assigned to observation services, CMS moved back the start date for the requirement in the 2017 IPPS final rule to “no later than 90 days,” after the final version of the form is approved.
The August 2 issue of Revenue Cycle Daily Advisor included a question about benchmark conversion rates from observation to inpatient status. With regard to that question, I think it may be helpful to know the average national conversion rate and average rate for critical access hospitals. Do you have that information?
