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New modifiers for outpatient never events; billing for hospital-acquired conditions

This week, CMS published the July Integrated Outpatient Code Editor (I/OCE).  Although there were relatively few changes, CMS did introduce three new modifiers for use with the occurrence of three never events identified by the National Quality Forum (NQF) that were recently the subject of National Coverage Analyses by CMS.  The new modifiers are: PA for surgical or invasive procedure on the wrong body part, PB for surgical or invasive procedure on the wrong patient, and PC for wrong surgery or invasive procedure on patient.  The modifiers were added to the list of valid modifiers effective January 1, 2009.

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Proposed FY 2010 IPPS Rule – An overview

On Friday May 1, CMS released the proposed inpatient prospective payment system (IPPS) rule for FY 2010.  Hospitals, including long-term-care hospitals (LTCs) and certain other non-IPPS hospitals (e.g., CAHs), are encouraged to review the proposed rule and to provide written comments to CMS by 5:00 p.m. E.S.T. on June 30, 2009. [more]