Thursday, February 25, 2021
- Billing for Services when Medicare is a Secondary Payer
- April 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits
- Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - April 2021
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News
CMS Offers Comprehensive Support to the State of Texas to Combat Winter Storm
On February 22, CMS announced that efforts are underway to support Texas in response to severe winter storms that have affected the state over the past several days. On February 17, HHS Acting Secretary Norris Cochran declared a public health emergency for Texas retroactive to February 11. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of the storm.
Compliance
Post-Acute Care Transfers: Bill Correctly
In a recent report, the Office of Inspector General (OIG) found Medicare improperly paid inpatient claims subject to the transfer policy. Many hospitals didn’t properly code inpatient claims as a discharge to home when patients resumed home health services within 3 days of discharge. Read the Review of Hospital Compliance with Medicare's Transfer Policy with the Resumption of Home Health Services & Other Information on Patient Discharge Status Codes (PDF) MLN Matters Article to bill correctly.
Visit the FY 2021 Inpatient Prospective Payment System (IPPS) Final Rule webpage to stay up to date on the latest policy changes and payment updates. Learn more about:
- Adjustment bills involving time limitations for filing claims: Medicare Claims Processing Manual, Chapter 1 (PDF), Section 130.1.1
- Transfers between IPPS Hospitals: Medicare Claims Processing Manual, Chapter 3 (PDF), Section 20.1.2.4
- Decisions and determinations regarding claim reopening and revision: Medicare Claims Processing Manual, Chapter 34 (PDF)
MLN Matters® Articles
Billing for Services when Medicare is a Secondary Payer
CMS issued a new MLN Matters Special Edition Article SE21002 on Billing for Services when Medicare is a Secondary Payer (PDF). Learn what to do when the diagnosis codes on a current claim are the same, or within the same family, as the diagnosis codes on the Liability, No-Fault, or Workers’ Compensation Medicare Secondary Payer record, but the service is not related.
April 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
CMS issued a new MLN Matters Article MM12133 on April 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (PDF). Learn about new and revised pricing files
Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits
CMS issued a new MLN Matters Article MM12131 on Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits (PDF). Learn about new codes for 2021.
Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - April 2021
CMS issued a new MLN Matters Article MM12128 on Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - April 2021 (PDF). Learn about codes, payment amounts, and supplier files.
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