Medicare Compliance & Reimbursement
PHYSICIANS:
'Medically Unbelievable' Edits Put On Hold
Published on Sat Feb 19, 2005
No explanation for revocation. CMS Sets No Update Schedule CMS said it has no plans to issue a replacement or update for the transmittal, meaning the "Medically Unbelievable" edits appear to have suspended their disbelief - at least for now.
The Centers for Medicare and Medicaid Services has rescinded Transmittal 105, which detailed how Adminastar Federal would issue edits for units of particular codes that seemed unrealistic.
Other Articles in this issue of
Medicare Compliance & Reimbursement
- HOSPITALS:
Physician-Owned Hospital Payments Might Fall After DRG Changes
Moratorium likely to last until 2007.
Do physician-owned hospitals that focus on one narrow specialty hurt [...] - HIPAA:
HIPAA Error? You'll Hear From Carriers
Unsuccessful crossover claims will prompt auto notice.
Starting July 5, Medicare contractors will issue special automated [...] - APPEALS:
New Complex Procedures Appeals Rule May Make Physicians Dizzy
Decide in advance what kind of representation to offer.
Appealing claims next year could become simpler [...] - LONG-TERM CARE:
LTC Industry Challenges MedPAC On Recommendations
Stingy inflation policy threatens quality care.
Long-term care industry groups are taking aim at the Medicare [...] - DRUG COVERAGE:
MMA Steps Up Screening Test Coverage
But Medicare wants a V code, not a G code, when reporting a screening.
Physicians now [...] - PHYSICIANS:
Count On Local Carriers For Least Costly Policy Fixes
PPAC: CMS to remove drugs from update formula retroactively.
Least costly alternative policies create an "unlevel [...] - COVERAGE:
CMS Expands Defibrillator Coverage
Transmittal states Medicare HMO patients can get fee-for-service devices.
Patients should be able to receive an [...] - COVERAGE:
Currently, Not All Physicians Enamored With P4P Proposal
P4P must be voluntary, docs contend.
The pay-for-performance movement seems well on its way in health [...] - ENFORCEMENT:
Transport Owner Sidelined 7 Years
Getaway effort by provider no match for law's long arm.
Providers caught in the crosshairs of [...] - HOSPITALS:
Note These OPPS Changes To Avoid Future Trouble
Make sure you're billing correctly for mammographies, observation.
If your facility is receiving denials for services [...] - LABS:
CMS Alters C-Peptide Test Requirement
Lower limit is key.
For services performed on or after Dec. 17, 2004, a positive fasting [...] - BILL WATCH
The following bills were introduced in the House:
HR. 1166. A bill to amend title XVIII [...] - PHYSICIANS:
'Medically Unbelievable' Edits Put On Hold
No explanation for revocation.
The Centers for Medicare and Medicaid Services has rescinded Transmittal 105, which [...]
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