The week in Medicare updates
APCs Insider, August 15, 2014
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
CMS releases October 2014 OPPS update
On August 1, CMS released a Recurring Update Notification describing changes to and billing instructions for various payment policies implemented in the October 2014 OPPS update. Several new HCPCS codes were included in the update.
Effective date: October 1, 2014
Implementation date: October 6, 2014
View Transmittal R3012CP.
View MLN Matters® MM8873.
Part B rebilling edit corrections and instructions
On August 1, CMS released a change request to modify FISS Part B claim overlap edits related to CMS-1599-F for outpatient TOB 13x and 12x. The transmittal also instructs providers that they may offset the Part B co-payment from the Part A deductible or co-payment the patient may have already paid.
Effective date: January 1, 2015
Implementation date: January 5, 2015
View Transmittal R1412OTN.
View MLN Matters MM8820.
CMS removes user-controlled effective date to apply therapy caps to CAH claims
On August 1, CMS released a transmittal regarding the application of therapy caps to outpatient therapy services provided in critical access hospitals (CAHs), which was initially implemented on a time-limited basis. As a result of subsequent rulemaking, this policy is no longer time-limited and is not subject to periodic legislative extensions. This transmittal revised Medicare systems to remove user-controlled effective dates from the process which applies the therapy caps to CAH claims.
Effective date: January 1, 2015
Implementation date: January 5, 2015
View Transmittal R1411OTN.
OIG finds Part D beneficiaries with questionable utilization patterns for HIV drugs
On August 6, OIG posted a report detailing Part D beneficiaries with questionable drug utilization patterns.
View the report.
Summer HOP Panel meeting and agenda now scheduled for one day only
On August 6, CMS announced the summer 2014 Hospital Outpatient Payment (HOP) Panel meeting and agenda is now scheduled for one day only, Monday, August 25. The public meeting start time is unchanged and it is anticipated the meeting will conclude on Monday no later than approximately 12 p.m. View the story.
TMVR coverage updated
On August 7, CMS posted a decision memorandum regarding coverage of Transcatheter Mitral Valve Repair (TMVR). TMVR is covered for the treatment of significant symptomatic degenerative mitral regurgitation when furnished according to an FDA-approved indication and other conditions are met.
View the decision memorandum.
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Related Products
Most Popular
- Articles
-
- Math can be tricky: TJC corrects ABHR storage requirement
- Air control equals infection control
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Five ways to safeguard your patients' valuables
- The consequences of an incomplete medical record
- Q&A: Primary, principal, and secondary diagnoses
- OB services: Coding inside and outside of the package
- Skills of effective case managers
- Practice the six rights of medication administration
- E-mailed
-
- Air control equals infection control
- OSHA HazCom updates include labeling, SDS requirements
- Plan of Care Supports Documentation of Homebound Status
- Note similarities and differences between HCPCS, CPT® codes
- Note from the instructor: CMS clarifies billing guidelines on proper billing for drugs in a single-dose or single-use vial, including billing for discarded drugs
- Neurological checks for head injuries
- Modifiers and medical necessity
- Follow these tips to properly report bladder catheter codes
- Five ways to safeguard your patients' valuables
- Differentiate between types of wound debridement
- Searched