CMS recently released the 2019 NCCI Policy Manual for Medicare Services, which includes updates to payment policies and coding methodologies effective January 1.
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 debridement documented or only the size of the skin substitute?
NAHRI members tuned in for expert analysis of new and upcoming changes including inpatient admission order requirements, appropriate use criteria, and learned how to apply for the association’s new credential during NAHRI’s October 30 quarterly members-only call.
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.
CMS’ latest payment system changes and the implications for 2019 and beyond made waves on day one of the 2018 Revenue Integrity Symposium in Litchfield Park, Arizona. Attendees at the back-to-back general sessions on October 16 had the opportunity to ask revenue integrity experts questions about the 2019 outpatient prospective payment system (OPPS) and Medicare physician fee schedule (MPFS) proposed rules and revenue integrity hot topics, including price transparency, Medicare Advantage contracting, noncovered services, and more.
