Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e. C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1.
Q: We are in the middle of changing the hospital methodology for charging cardiac cath procedures within Epic CUPID. What is your hospital’s workflow for charging cardiac cath procedures?
Take an in-depth look at the 2020 IPPS final rule to ensure your organization is ready for a major revision to the hospital wage index calculation and more.
