Hospital articles
Temporarily deactivating reason codes 31006 and 31007 for CAH method II claims
Read this article for important information for method II CAH facilities receiving reason codes 31006 and 31007.
Critical access hospitals (CAHs) professional claims line-item date of service (LIDOS) with revenue codes 096X, 097X and 098X are being denied (status D) for not having physician reassignments on file
Critical access hospitals (CAHs) professional claims line-item date of service (LIDOS) with revenue codes 096X, 097X and 098X are being denied (status D) for not having physician reassignments on…
Guidance on hospital inpatient admission decisions
In this special edition article, CMS stresses the importance of staying informed of all CMS national inpatient hospital policy and national and local coverage determinations regarding making a…
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
Activation of systematic validation edits for OPPS providers with multiple service locations
This article is for the activation of systemic edits for outpatient prospective payment system (OPPS) providers that have multiple service locations submitting claims to A/B MACs.
Part A outpatient infusion and hydration services
Read this article for important billing information for outpatient infusion and hydration services.
Inpatient hospital entitlement changes
When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will determine whether to bill the Medicare Advantage plan and/or original…
Inpatient admitted prior to entitlement
There are special billing guidelines to follow when the beneficiary becomes entitled to Part A benefits in the middle of an inpatient stay.
Long term care facility prospective payment system standard versus site neutral payment
For discharges on or after October 1, 2015, there are two separate payment categories for long term care hospital (LTCH) patients. This article provides those details.