Important Medicare updates
Medicare Update for CAHs, April 18, 2012
On April 4, CMS rescinded Transmittal 2368 dated December 15, 2011, and replaced it with Transmittal 2437. The new transmittal corrects language in Chapter 17, section 20.1.3, paragraph three of the Medicare Claims Processing Manual, specifically it changes the effective date of the flu season from September 1 to August 1 and to changes “this file” to “payment allowance limits.” All other material remains the same.
Effective Date: January 1, 2013
Implementation Date: January 1, 2013
On April 9, CMS released a proposed rule announcing a one-year delay of the implementation of ICD-10-CM/PCS. If finalized, ICD-10 would become effective October 1, 2014.
CMS updates additional documentation limits for Recovery Auditors
On March 12, CMS issued an update that effectively raises the additional documentation requests (ADR) limits for Recovery Auditors. Beginning March 15, 2012, ADR limits will increase to 2% of all claims submitted in the prior calendar year, divided by eight. This represents a 1% increase from 2011. In addition, the maximum number of requests per 45 days is now 400, which is an increase of 100 from last year. Recovery Auditors may request up to 35 records per 45 days from providers whose calculated limit is 34 records or less.
CMS updates NCDs
CMS has posted a new version of the lab NCD manual for the second quarter.
OIG posts interactive map with Medicaid Fraud Control Unit data
The OIG posted an interactive map of the United States to its website that shows information from each state’s Medicaid Fraud Control Unit including investigations, convictions, recoveries, and expenditures for fiscal year 2011. The OIG also posted a written summary of the statistics.
- Differentiate between types of wound debridement
- Complications from immobility by body system
- OB services: Coding inside and outside of the package
- Don’t forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- What does case-mix index mean to you?
- Pneumonia with a negative chest x-ray: Clinical diagnoses, physician documentation, and coding guidelines
- ICD-10 tip: Coding for infectious and parasitic diseases
- ICD-10-CM coma, stroke codes require more specific documentation
- Fracture coding in ICD-10-CM requires greater specificity
- Initiative launched to prevent physician, medical trainee suicides
- I Have to Learn This, Too?
- How surviving a disaster changes the disaster plan
- Gap analysis: Three big issues
- Ensure compliance when reporting cirrhosis and alcoholic hepatitis with an MCC
- CMS seeks comment on Medicaid HCBS
- CMS launches new online tool to make Quality Payment Program easier for clinicians
- Assessing weapons in your healthcare facility
- Analyzing nurse staffing: Understanding FTEs
- A clarification on billing for CAH swing bed services