Health Information Management

Pay-per-view: CMS releases details on Part A to B rebilling

APCs Insider, June 21, 2013

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Providers were glad to see CMS' ruling (CMS-1455-R) released March 13 (published in the Federal Register on March 18), which allows full Part B payment for inpatient stays that had been denied as not reasonable and necessary. The ruling had very few details on how the process would work, but on March 22, CMS published Transmittal R1203OTN instructing contractors and providers on the details.

Inpatient cases that have been denied as not reasonable and necessary, including those where the provider has pending appeals, are rebilled on at least two and possibly three separate claims depending on when the services are rendered.
 
Continue reading CMS releases details on Part A to B rebilling on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the June issue.



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