Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
The following was written by Reg Hislop for Reg’s Blog. Reposted with permission. . The SNF proposed rule is best characterized as mostly good news. The best news is the proposed market-basket (rate inflation) update of 3%. Subtracting the productivity factor of .5% from the update, SNFs will see a rate increase of 2.5% starting […]
CMS has released an update on therapy caps and functional reporting. Effective for dates of service on or after January 1, 2018, providers of therapy services shall continue to report the KX modifier on claims as applicable; however, the modifier no longer represents an exception request but serves as a confirmation that services are medically […]
The National Association for Healthcare Revenue Integrity (NAHRI) is currently seeking speakers to present at the 2019 Revenue Integrity Symposium (RIS), to be held October 15–16, 2019, at the Renaissance Orlando at SeaWorld in Orlando, Florida. RIS attendees will be eligible to earn CHRI CEUs and speakers will be eligible to earn additional CHRI CUEs. […]
Source: The Bottom Line CMS posted a new DRAFT version of the 2019 MDS item sets (v1.17.0) last week. This version is scheduled to become effective October 1, 2019, giving facilities until then to update their software with the new MDS questions and answers. Downloadable files can be accessed here: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation.html HCPro’s post-acute regulatory specialist […]
The Billers’ Association for Long-Term Care (BALTC) is a membership community created specifically for professionals involved in the long-term care revenue cycle. This national association provides members with a resource of continuously updated tools, reimbursement and regulatory guidance, and education to help prevent revenue loss and documentation and billing errors so providers can withstand audits […]
Source: The Bottom Line Medicare covers urinary catheters and external urinary collection devices when they are used to drain or collect urine for a resident with permanent urinary incontinence or permanent urinary retention. According to CMS, permanent urinary retention occurs when the condition is not expected to be medically or surgically corrected within three months. […]
By The Bottom Line. MedPAC released their Payment Basics for SNFs 2018 report, which provides an overview of Medicare coverage and reimbursement. You can download this resource from The Billers’ Association resource library. The report includes a map explaining how reimbursement is calculated under the current prospective payment system, Medicare daily base rates for FY19, […]
From The Bottom Line The MACs for the J5 (Iowa, Kansas, Missouri, and Nebraska) and J8 (Indiana and Michigan) jurisdictions (WPS Government Health Administrators) announced that CMS has authorized them to conduct a Targeted Probe and Educate (TPE) review of outpatient therapy (CPT code 97110). The announcement was made on October 15 on the WPS […]
By The Bottom Line. In an MLN Matters article issued on October 5, 2018, CMS described systems changes they made to ensure SNFs and swing beds bill Occurrence Code 22 correctly. It also ensures the same benefit period logic used for SNF claims is used for swing bed claims. As a result of these changes, […]
By The Bottom Line. The Centers for Medicare & Medicaid Services published the following summary of errors published in the FY2019 SNF PPS final rule: In Tables 6 and 7 on pages 39170 through 39172, we made errors in copying values into the “total rate” column of the tables used in the final rule preamble, […]