The Outpatient Prospective Payment System (OPPS) proposed rule put on display by CMS on July 8. In it, CMS proposes significant changes to the ambulatory payment classifications (APC) packaging system and visit codes to further bundle and consolidate...Read More »
In its FY 2014 IPPS proposed rule, CMS not only redefines inpatient status, but it also discusses the ‘why’ and ‘how’ physicians should document the defining characteristic of all admissions: medical necessity.Read More »
New data released today show significant variation across the country and within communities in what hospitals charge for common inpatient services,...Read More »
Medical necessity for cardiovascular procedures is the top overpayment issue for three out of the four Recovery Auditors in FY 2013 first quarter (October 2012–December 2012), according to the most recent release of...Read More »
It was hardly explicit that organizations could rebill on an outpatient basis (or fully bill) for services denied as non-medically necessary in an inpatient setting. However, on March 13, CMS issued a...Read More »