Q: Does the concurrence of the attending physician, that is required for condition code 44, need to be recorded by the attending physician, or can another practitioner write the concurrence
Q: Did something change with the observation services composite APC in 2016? The director of patient financial services says we no longer receive payment for it.
Q: Will a self-denial billed with condition code W2 have the same effect on the skilled nursing facility (SNF) three-midnight qualifying stay requirement as condition code 44?
The 2016 OPPS final rule includes the first negative payment update for the system. CMS finalized its proposal to reduce the conversion factor by 2% to account for its overestimation of dollars for packaged labs built into the 2014 APC rates, despite congressional and provider pressure to not proceed with this payment reduction.
On November 16, 2015, CMS released a final rule that bundles acute-care payments for knee and hip replacement surgeries, the most common type of inpatient surgeries for Medicare beneficiaries, with some 400,000 performed in 2004.
This week’s updates include a fact sheet about the Accountable Care Organization Investment Model; fact sheets regarding the Medicare Shared Savings Program; and more!
