Q: The physician documented debridement (11043x1 & 11046x4) of a wound 85.25 sq. cm and documented 20 sq. cm of skin substitute application (15271). My coder says that 11043/11046 is included in 15271 and we can't separately bill for them with 15271. Do we bill 15271 as the size of the...Read More »
Most inpatient rehabilitation facility stays might not meet Medicare coverage or documentation requirements and compliance could be improved through a preauthorization process, according to a recent Office of Inspector General report.Read More »
In the 2019 OPPS final rule, released Friday, November 2, CMS implemented several site-neutral payment policies, though the agency did delay or shelve other proposals due to stakeholder feedback. Read More »
Q: How are you carving out other services from observation? Are you using a standard time or calculating based on the time off the nursing unit? What services are you carving out? Are you carving out services for other non-Medicare payers?Read More »
The high volume of successful appeals, particularly on the first level, raises concerns that Medicare Advantage Organizations were denying payment and authorization for services that should have been provided, the OIG said.Read More »
