Author Archive for Michael Iarrobino
Michael Iarrobino, CPC-A, is a Web editor for HCPro’s revenue cycle division. He writes and edits content related to coding, compliance, and revenue cycle, and serves as the manager of MedicareFind™.
Providers report first RAC denials in Florida, South Carolina
Over at the Revenue Cycle Institute, my colleague Andrea Kraynak has a great post on the first RAC denials that we’re seeing so far. There’s some really solid, in-depth information there regarding the experiences of two providers with RAC denials and even a discussion of particular CPT codes affected. Great information for all of us looking to stay on top of this evolving issue.
MedicareFind tip: How to access the inpatient-only list
MedicareFind users have been sending in some really great questions lately — thanks for your interest in learning how to use this product! One that I want to tackle today is about finding CMS’ list of inpatient-only procedures.
CMS publishes the inpatient-only list with each OPPS final rule as Addendum E . The best way to access this in MedicareFind is to do a FIND for “Addendum E”, then apply the “Data Files” filter — this will make it so you are seeing a list of documents in the Excel data file format that CMS releases (rather than, for example, the Federal Register format). From here you can use the “Year” filters to access whichever inpatient-only list you need.
You can also access the inpatient-only list by using Addendum B, which CMS updates quarterly. Perform a FIND for “Addendum B” and, as before, apply the “Data Files” filter. From here apply a “Year” filter, then pick the appropriate month depending on which quarter’s file you want. When you open up the Excel document, sort the data by status indicator. The codes with a “C” status indicator are inpatient-only procedures.
Happy FINDing! Sign up for a MedicareFind free trial today.
Sign up for our FREE MedicareFind webcast!
Join us Thursday, November 12, at 1 p.m. Eastern for our free MedicareFind Demonstration webcast.
I’ll show what MedicareFind has to offer and demonstrate features that can help save a lot of time as you search for the source authority documents you need. I’ll also address any live questions that we receive.
We’ve held a couple of these demos over the past few months and received great feedback from attendees — so I think this should be a great resource for current users looking to get the most out of MedicareFind or prospective subscribers evaluating whether this is the right product for them.
Go to the webcast page on HCMarketplace now to sign up for free.
October 8 Open Door Forum
The transcript and audio of the October 8 Hospital & Hospital Quality Open Door Forum are now available on MedicareFind.
This call featured a lengthy Q&A period, including discussion of:
- Services that require active monitoring and their relation to observation time
- Charges for nursing services
- H1N1 resources
… and more.
Sign up for a free trial to MedicareFind to access the transcripts and audio of this and previous ODF calls.
FIND quarterly updates
Flipping over the calendar from September to October means there are plenty of updates available to MedicareFind subscribers.
The latest versions of the NCCI edits, both on the physician and hospital outpatient side, have been loaded into our NCCI edit lookup tool. Keep in mind that the hospital outpatient edits are one quarter behind the physician edits.
The quarterly updates to the medically unlikely edits (MUE) is available. As before, some of the MUEs remain unpublished.
And you can now locate the following, in addition to other quarterly changes:
- Third quarter updates to OPPS Addendum A and Addendum B
- The October 2009 lab NCD manual
- The latest I/OCE update
Sign up for a free trial to MedicareFind to access updates like these and more.
MedicareFind tip: Use spotlighting to FIND particular documents
You may often be unsure of which exact document will answer your questions. In these cases, entering keywords into MedicareFind and using the filters and sorting to explore the available guidance is the best method of FINDing the guidance you need.
Sometimes, however, you already know which particular transmittal, MLN Matters article, Job Aid article, program memorandum, or regulation you need. Wouldn’t it be nice if you didn’t have to do any sorting, filtering, or navigating to access it?
MedicareFind can help.
Enter the full transmittal number (e.g., R1745CP), MLN Matters article number (e.g., MM6619), Job Aid article number (e.g., JA0902), or regulation number (e.g., CMS-1414-P), and MedicareFind will spotlight the exact matching document at the top of your results.
Additional results may be there if that reference number is mentioned within other documents (in fact, you may find these results useful in knowing whether the document you have in mind has been superseded), but you do not have to sort through anything to access the source authority you had in mind.
Purchase MedicareFind to start FINDing. You can also sign up for a free trial.
More on observation services: The Medicare Compliance Forum
Frequent MedicareMentor readers will be aware of the series of posts my colleague Kimberly Hoy has written on observation services — read the ongoing discussions here, here, and here. You can hear Kimberly say a bit more about the cluster of issues surrounding observation at the upcoming Medicare Compliance Forum.
The “Medicare Compliance Forum: A Strategic Approach to RACs, Observation Status and the Role of Physician Advisors”, is an upcoming seminar with a whole track of sessions that will help you resolve observation-related questions and problems. Kimberly joins other experts such as ACS’ Deborah Hale, CCS, and Executive Health Resources’ Joe Zebrowitz, MD.
I’ve found the back-and-forth on observation here on the MedicareMentor Blog to be very substantive and illuminating (many thanks to those who’ve commented!), and you can expect the same rigorous, source-based analysis in the forum sessions.
Check out the event brochure, additional tracks, and more on the Medicare Compliance Forum page.
Free MedicareFind on-demand webcast
Thanks to everyone who participated in the MedicareFind webcast we held on July 22. I’m happy to announce that this is now available as a free on-demand recording — it should be a good resource for folks hoping to improve their use of MedicareFind.
During the webcast, HCPro’s Director of Medicare and Compliance (and fellow blog participant) Kimberly Hoy discussed three developing regulatory topics:
- Physician supervision (changes for 2009 and proposed 2010 changes)
- Counting observation hours
- HACs
I provided some demonstrations of how you can use MedicareFind to access the primary authorities in these areas and stay current with future updates.
To access the webcast, start here and go through the signup process. Happy FINDing!
CGI posts approved issues for Region B
Region B, get ready. RACs may begin auditing at any time in several Region B states.
CGI Federal, the RAC for Region B, has posted its first set of issues eligible for RAC audits in Indiana, Michigan, and Minnesota.
The approved issues target outpatient hospital and physician claims and correspond with those approved for many states in RAC regions C and D that were posted over the past few weeks — take a look at the discussions here, here, and here for more.
Check out more RAC-related coverage over at the Revenue Cycle Institute.
RAC program: Connolly posts approved issues for Florida
UPDATE: Blood transfusions have since been approved for review in Florida.
Connolly Healthcare, the RAC for region C, has now posted issues for review in Florida.
Similar to South Carolina, RACs may now audit providers in Florida on the following five issues:
- Untimed Codes
- IV Hydration Therapy
- Once in a lifetime procedures
- Pediatric codes exceeding age parameters
- J2505: Injection, Pegfilgrastim, 6 mg
Note that CMS has not approved audits of bronchoscopy services or blood transfusion at this time for Florida providers.
Connolly has not yet posted approved issues for other states and territories in the region, including Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, New Mexico, Oklahoma, Tennessee, Texas, West Virginia, as well as Puerto Rico and the U.S. Virgin Islands.
Hat tip to my colleague Andrea Kraynak at the Revenue Cycle Institute. Thanks Andrea!
