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COVID-19 FAQs on Medicare Fee-for-Service Billing Updated Again

In COVID-19, News by Mary MadisonLeave a Comment

This 140-page COVID-19 FAQ document was updated on July 28, 2020. This is what’s new in this version during July: Page 10 – Diagnostic Laboratory Services … Question: If a physician/non-physician practitioner (NPP) reports CPT code 99211 “Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician”, …

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News Alert: Provider Reimbursement Available for Counseling Patients to Self-Isolate at Time of COVID-19 Testing

In COVID-19, News by Mary MadisonLeave a Comment

The following News Alert was issued mid-day on Thursday, June 30, 2020: CMS and CDC announce provider reimbursement available for counseling patients to self-isolate at time of COVID-19 testing Today, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to …

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Hospice PEPPER Now Available

In Hospice, News by Mary MadisonLeave a Comment

The Q4FY19 release of the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2019 is now available for download through the PEPPER Resources Portal. To obtain your Hospice PEPPER, the Chief Executive Officer, President, Administrator, Compliance Officer, or Quality Assurance/Performance Improvement Officer of your organization should: Review the Secure PEPPER Access Guide. Review the instructions and obtain …

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OIG Report: Medicare Overpaid HHAs $191.8 Million

In Home Health, News by Mary MadisonLeave a Comment

The Office of Inspector General released a report this last week of July that revealed overpayment of home health agencies. The OIG audit covered approximately $1.25 billion in Medicare payments to HHAs for 549,768 claims. These claims were for home health services provided in CY 2017. Because of the large increase in payment starting with the fifth visit, OIG focused …

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[Free webinar, Jul 29] Prepping for PBJ quarterly success: Critical answers to your top questions

In Long Term Care, Webinars by Mary MadisonLeave a Comment

After a bumpy three-month ride, PBJ reporting is back on track for the quarter. In late March, CMS issued a staffing data submission waiver due to the COVID-19 public health emergency.  On June 25, that waiver ended – which means PBJ reporting requirements for the quarter are back in effect. In this free webinar, find out the latest PBJ news and get …

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SNF PEPPER Reports Are Coming

In Long Term Care, News by Mary MadisonLeave a Comment

In case you forgot about your annual PEPPER report, CMS has not.  CMS has directed the PEPPER team to resume distribution of PEPPER reports to all post-acute facilities. The SNF Q4FY report will be delivered on July 29, 2020.  It was originally scheduled for release on April 6, 2020 but it was held at that time due to the COVID-19 …

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FY 2021 ICD-10-CM Official Guidelines for Coding and Reporting Posted

In ICD-10, News by Mary MadisonLeave a Comment

The FY 2021 ICD-10-CM Official Guidelines for Coding and Reporting have been posted a bit earlier than usual this year.  The 126-page document provides the guidelines for diagnosis coding.  These guidelines are to be used from October 1, 2020 through September 30, 2021. Note: This (document) replaces the FY 2020 release. These files listed below represent the FY 2021 ICD-10-CM. …

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It’s Back! Review Choice Demonstration Returns.

In Home Health, News by Lisa Selman-Holman2 Comments

It’s ba-a-a-c-c-k-k !  Review Choice Demonstration returns! If you are a home health provider in Illinois, North Carolina, Ohio, Florida or Texas, CMS will “discontinue exercising enforcement discretion” for the Review Choice Demonstration for Home Health Services beginning on August 3, 2020, regardless of the status of the public health emergency. The initial choice selection period will begin in North …