Codes with an I or X indicator will now be reportable
Some HCPCS codes are not payable by Medicare because they represent transportation and transportation related services. The Centers for Medicare and Medicaid Services (CMS) released a transmittal that instructs contractors to modify their claims processing systems to allow these codes to be reported.
HHS announces new coverage
The Department of Health and Human Services (HHS) adopted additional Guidelines for Women’s Preventative Services, under the Patient Protection and Affordable Care Act (PPACA). The new items that will be covered include well-woman visits, support for breastfeeding equipment, contraception, and domestic violence screening. This new regulation will require that these services be covered without any cost sharing in all new health plans starting in August 2012.
CMS proposes new rule to improve ESRD treatment for 2012
The Centers for Medicare and Medicaid Services (CMS) have proposed the 2012 rates for dialysis treatment facilities that see End Stage Renal Disease patients with Medicare. The rule will affect services provided on or after January 1, 2012
CMS proposes 2012 provisions
The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule to determine the 2012 payment rates for home health care. The rule was on display July 5th on the Federal Register.
Program seeks to reduce harm in hospitals and readmissions
A new program mandated by the Affordable Care Act (ACA) will provide up to $500 million to “Hospital Engagement Contractors.” These federal contractors will compete to receive the funds from the Department of Health and Human Services (HHS).
The Office of the Inspector General (OIG) conducted a study sampling 780 Medicare patients who had at least one hospital stay in October 2008. The study looked for serious events on the National Quality Forum’s (NQF’s) “adverse event” (or “never events”) list, the Medicare Hospital Acquired Conditions (HAC) list, and the four most severe categories of the National Coordinating Council for Medication Errors Reporting and Prevention (NCC MERP) Index for Categorizing Errors. The study then used a team of physicians to analyze which events were reasonably preventable.
CMS proposes rule as part of the PPACA
Using both Medicare and private sector claims data, the Centers for Medicare and Medicaid Services (CMS) have proposed a system for evaluating the cost of practices versus performance. This new rule is authorized under the Patient Protection and Affordable Care Act (PPACA) and intends to curb rising health care costs by providing greater transparency to the market.
The program would appoint “qualified entities” which would have the authority to monitor claims data while being responsible for possibly sensitive patient health information. The “qualified entities” would process claims data from both Medicare and private insurance providers in order to show what practices are charging (on average) for certain procedures. Using this data, the “qualified entities” would create reports comparing different prices to different outcomes for each provider, which would be made available to the public.
The mystery behind ICD-9 code 289.81
Tucked under the Syndrome section of the ICD-9 Alphabetical Index, you can find Antiphospholipid Antibody, code 289.81. Flipping over to the Diseases of the Blood and Blood—Forming Organs section, there it is: “Primary hypercoagulable state.” But it’s more than just a number; it is a disease that is often misunderstood.
One at a time, please
CMS officials say, providers no longer have to personally attest for meaningful use of their electronic health records (EHR) systems, however only one register or attest per provider at one time.
3,500 hospitals will now be paid under the program
A drastic deviation from the pay-per-procedure model, the Hospital Value-Based Purchasing program will reward hospitals for quality care instead of just quantity. The program’s launch was announced by the Department of Health and Human Services (HHS) on April 29, 2011.