Health Information Management

Medicare updates

APCs Insider, May 10, 2013

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FAQs available for revised and clarified Place of Service (POS) coding instructions “Revised and Clarified Place of Service (POS) coding instructions” became effective April 1, 2013. Since publication, questions have been raised about the general Medicare requirements for billing the global diagnostic code, date of service, POS for pathology and laboratory services, enrollment, MAC jurisdiction, and claims processing requirements.

View the FAQs
View MLN Matters article MM7631.
 
June 30 deadline to avoid 2014 eRx payment adjustment
In CY 2014, a payment adjustment will be applied to eligible practices’ Medicare Part B Physician Fee Schedule (PFS) covered professional services for not becoming a successful electronic subscriber. Eligible parties participating in eRx GPRO who were not successful electronic prescribers in 2012 can avoid the payment adjustment by meeting specified reporting requirements between January 1 and June 30, 2013.
Click here for additional information.
 
CMS posts updated EHR FAQs on Sequestration and Attestation
CMS has posted two updated FAQs related to EHR Incentive Programs, including information on how EHR incentive payments will be affected by sequestration and guidance on how to successfully attest following an EHR vendor transition.
View the FAQs here and here.
 
Revised MLN Matters article: “Questionable Billing by Suppliers of Lower Limb Prostheses”
“Questionable Billing By Suppliers of Lower Limb Prostheses” includes an overview of major OIG findings, and recommendations related to Medicare requirements for lower limb prostheses. The article was revised to remove information from page 5.
View Special Edition MLN Matters article SE1213.
 
Revised MLN Matters article: “HIPAA Eligibility Transaction System (HETS) to Replace Common Working File (CWF) Medicare Beneficiary Health Insurance Eligibility Queries”
“HIPAA Eligibility Transaction System (HETS) to Replace Common Working File (CWF) Medicare Beneficiary Health Insurance Eligibility Queries” includes important information and frequently asked questions (FAQs) providers can use to prepare for the transition. The article was revised to update FAQs and related language.
View Special Edition MLN Matters article SE1249.
 
CMS issues proposed rule regarding FY2014 payment and policy changes for SNFs
On May 1, CMS issued a proposed rule [CMS-1446-P] outlining proposed Fiscal Year (FY) 2014 Medicare payment rates for skilled nursing facilities (SNFs).
View the proposed rule.
View a related fact sheet.
 
CMS issues proposed rule regarding FY2014 payment and policy changes for IRFs
On May 2, CMS issued a proposed rule outlining fiscal year (FY) 2014 Medicare payment policies and rates for the inpatient rehabilitation facilities (IRFs) Prospective Payment System (PPS), and updates and changes for the IRF Quality Reporting Program (QRP). The proposed rule will appear in the May 8, 2013 Federal Register.
View the proposed rule.
View a related fact sheet.
 
OIG issues a report on Medicare Payments for Part B claims with G modifiers
On May 6, the OIG issued a report on a study that found vulnerabilities in how Medicare pays for Part B claims with G modifiers that providers expected to be denied as not reasonable and necessary or as not being covered by Medicare.
View the OIG report.
 
OIG issues report on Medicare hospice use of general inpatient care
On May 6, the OIG issued a report on findings related to Medicare hospital use of general inpatient care.
View the OIG report.



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