Training Programs
Audits & Assessments
Regulatory MonitoringArchive for Billing and reimbursement
- The hospital bill for laboratory services only after they are performed
- The hospital bill only for medically necessary services
- The hospital bill only for tests actually ordered by a physician and provided by the hospital laboratory
- The current procedural terminology or Healthcare Common Procedural Coding System code used by the billing staff accurately describes the service ordered
- The coding staff submit only diagnostic information obtained from qualified personnel and contact the appropriate personnel to obtain diagnostic information in the event that the individual who ordered the test has failed to provide such information
- The hospital document receipt of diagnostic information obtained from a physician or the physician’s staff after receiving the specimen and request for services
- Routine audits be conducted to assess your billing compliance with the regulations
The next Hospital & Hospital Quality Open Door Forum is scheduled for 2 p.m. Eastern, Thursday, November 19. To access the call, 800/837-1935 and reference conference ID: 34708559.
A transcript and audio recording of the conference call will be available to MedicareFind subscribers approximately one week after the Open Door Forum is held.
By Kimberly Anderwood Hoy, JD, CPC
This week, I would like to review a “clarification” regarding physician signatures on orders for clinical diagnostic testing that came out in the Final Rule for Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for 2010. Although this publication is hospital-directed and we do not normally report on physician fee schedule issues, this “clarification” could affect hospital policies on obtaining signatures for the laboratory services they provide.
Click over to the MedicareMentor Blog to read more.
CMS extends ESRD PPS comment period
On November 4, CMS published a notice in the Federal Register to extend the comment period on its proposal to initiate a prospective payment system (PPS) for end-stage renal disease (ESRD). The comment period on the ESRD PPS proposed rule will now end at 5 p.m., December 16.
The 2010 OPPS final rule released on October 30 contains few surprises, but does finalize two changes that received considerable attention when CMS proposed them.
“The information CMS has finalized for physician supervision and drug reimbursement are two key areas for hospital review, though for slightly different reasons,” says Jugna Shah, MPH, president of Nimitt Consulting in Washington, DC.
Click here to read more.
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