Corporate Compliance

Other Issuances: CMS updates FAQs, OIG issues report on oxaliplatin billing, and more

Medicare Insider, September 3, 2008

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Frequently asked questions

On August 28 and 29, CMS issued 50 new/updated frequently asked questions related to Medicare fee-for-service payment, coding, and billing.

View the fee-for-service-related frequently asked questions.

View the coding-related frequently asked question.

View the billing-related frequently asked questions.

OIG issues report on oxaliplatin billing at Kent County Memorial Hospital for calendar year 2004

On August 28, the OIG issued a report in which it determined that during calendar year 2004, Pinnacle Business Solutions, Inc. (a fiscal intermediary), overpaid Kent County Memorial Hospital $83,000 for outpatient oxaliplatin claims, due to incorrect units of service. The OIG recommended that Kent County return the overpaid amount and establish procedures to ensure that units billed for pass-through drugs correspond to the units of drug administered.

View the OIG report.

OIG issues report on Blue Cross and Blue Shield of Georgia Medicare payments to providers terminated from January 1, 2003, through January 31, 2007

On August 26, the OIG issued a report in which it determined that Blue Cross and Blue Shield of Georgia, a Medicare fiscal intermediary, made unallowable Medicare payments totaling $14,000 to two providers for services that were performed after the providers were terminated from Medicare.

View the OIG report.

OIG issues report on high-dollar payments for Rhode Island Medicare outpatient claims processed by Pinnacle Business Solutions, Inc., for calendar years 2004–2006

On August 26, the OIG issued a report in which it determined that during calendar years 2004–2006, Pinnacle Business Solutions, Inc. (a fiscal intermediary), overpaid providers in Rhode Island $141,000 for high-dollar (i.e., greater than $50,000) Medicare outpatient claims.

View the OIG report.

OIG issues report on Medicare payment for irinotecan hydrochloride

On August 26, the OIG issued a report in which it determined that in March 2008, the Medicare payment amount for irinotecan was more than double the OIG-calculated average manufacturer sales price. Based on this finding, the OIG recommended that CMS explore options to ensure that Medicare payment amounts for drugs with newly available generic versions accurately reflect market prices.

View the OIG report.

National Center for Health Statistics (NCHS) issues ICD-9-CM code conversion table

On August 13, NCHS issued an updated ICD-9-CM code conversion table, replacing an earlier update it issued July 17, to include the new procedure codes.

View the ICD-9-CM code conversion table.



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