The Northern California Chapter of HFMA has Local, State and National Healthcare News and Information to share with our members. The contents are informational only but are noteworthy for those in healthcare. We hope you find this information of interest and helpful. Please select your category of interest from the list on the right.
Centers for Medicare and Medicaid Services

CMS Finalizes 2018 Payment and Policy Updates for Medicare Hospital Admissions

Final rule supports transparency, flexibility, program simplification and innovation in the Medicare program August 2, 2017 – Today, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year 2018 Medicare Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System final rule, which updates 2018 Medicare payment...

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Medicare Learning Network

MM10183 – Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure to Procedure (PTP) Edits, Version 23.3, Effective October 1, 2017

Change Request (CR) 10183 informs the MACs about the update to the National Correct Coding Initiative (NCCI) procedure to procedure edits (PTP). This notice applies to Chapter 23, Section 20.9 of the Medicare Claims Processing Manual. Make sure your billing staffs are aware of these changes. View the full announcement

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Centers for Medicare and Medicaid Services

CMS New information regarding “MM10115 July 2017 Integrated Outpatient Code Editor (I/OCE) Specifications Version 18.2”

Change Request (CR) 10115 informs providers that the I/OCE is being updated July 1, 2017. The I/OCE routes all institutional outpatient claims (which includes non-Outpatient Prospective Payment System (OPPS) hospital claims) through a single integrated OCE. Make sure that your billing staffs are aware of these changes. Download the full...

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Centers for Medicare and Medicaid Services

MM9859 – Screening for Hepatitis B Virus (HBV) Infection

Change Request (CR) 9859 provides that the Centers for Medicare & Medicaid Services (CMS) has determined that, effective September 28, 2016, Medicare will cover screening for Hepatitis B Virus (HBV) infection when performed with the appropriate U.S. Food and Drug Administration (FDA) approved/cleared laboratory tests, used consistent with FDA-approved labeling...

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Centers for Medicare and Medicaid Services

MM9672 – Update FISS Editing to Include All Three Patient Reason for Visit Code Fields

This MLN Matters® Article is intended for providers submitting outpatient hospital claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries. Change Request (CR) 9672 informs MACs about changes that update logic in the Fiscal Intermediary Standard System (FISS) (Medicare’s system for processing institutional claims) to allow editing of...

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Centers for Medicare and Medicaid Services

CMS Rescinded: SE0801 – Clarification of Patient Discharge Status Codes and Hospital Transfer Policies

This article was rescinded on March 15, 2017. Information on the inpatient transfer policy is located in the “Medicare Claims Processing Manual” (100-04), Chapter 3. For questions concerning clarification on the proper usage of patient discharge status codes, providers should be utilizing the “UB-04 Manual” which is maintained by the...

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