CMS Hospital Acq Conditions

Hospital-Acquired Conditions and Present on Admission Indicator Reporting Provision Fact Sheet — Revised (from CMS)

CMS published a revised Hospital-Acquired Conditions and Present on Admission Indicator Reporting Provision Fact Sheet. Learn about: Background As required by the Defcit Reduction Act of 2005 (DRA), the HAC-POA Indicator Reporting provision requires a quality adjustment in Medicare Severity-Diagnosis Related Group (MS-DRG) payments for certain HACs. IPPS hospitals must...

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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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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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