Healthcare News: CMS guidance clarifies instructions for reporting services spanning October 1
HIM-HIPAA Insider, October 5, 2015
Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!
Providers need to report all services from October 1 forward with ICD-10 codes, but many will likely face scenarios with patients whose dates of service begin prior to October 1 and end after implementation. CMS has released special guidance to clarify how those instances would be billed with each bill type in MLN Matters® SE1325.
On a Type of Bill (TOB) 12X for reporting inpatient Part B hospital services, CMS requires providers to split claims so that all ICD-9-CM codes remain on one claim with dates of service through September 30. All claims with dates of service beginning October 1 or later are required to be reported with ICD-10 codes. Providers should use the “from” date to determine the dates of service, not the “through” date.
For TOB 11X with inpatient hospital services, if the claim has a discharge and/or through date on or after October 1, the entire claim should be reported with ICD-10 codes.
CMS has included example bills for ED and observation services in MLN Matters SE1325 and recommends providers check with individual payers to determine how they will handle claims that split the implementation date.
For more information, CMS has also released MLN Matters SE1408 with additional guidance.
Editor’s note: This article originally appeared on JustCoding.com.
Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!
Related Products
-
Briefings on APCs
Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...
-
HIM Briefings
Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...
-
Briefings on Coding Compliance Strategies
Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...
-
Briefings on HIPAA
How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...
-
APCs Insider
This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Practice the six rights of medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Code diagnoses and outpatient treatment for PTSD
- What to include on the incident report
- OB services: Coding inside and outside of the package
- Q&A: Primary, principal, and secondary diagnoses
- Differentiate between types of wound debridement
- Complications from immobility by body system
- Know guidelines and subtle differences in code descriptions for laceration repairs
- E-mailed
-
- Does anyone know where the standard is relating to oxygen cylinder storage?
- Note from the instructor: Billing Outpatient Laboratory Services - TOB 131 vs. TOB 141
- Security checkpoint: Will metal detectors really make a big difference
- History and development of shared governance
- Free tool: Peer evaluation tool for charge nurse
- Follow these tips to properly report bladder catheter codes
- Documentation: Legal risks for nurse managers
- Differentiate between types of wound debridement
- CPT coding for urgent care clinics
- Correctly bill ancillary bedside procedures in addition to the room rate
- Searched
