The Medicare Advantage hospice carve-in will change shape a bit next year, Medicare officials have revealed. “Under the Value-Based Insurance Design (VBID) Model, in Calendar Year (CY) 2024, thirteen Medicare Advantage Organizations (MAOs) will participate in the Hospice Benefit Component, [...]
Don’t jump the gun on VBID hospice changes for Medicare Advantage. “Starting in CY 2024, the Value-Based Insurance Design (VBID) Model’s hospice benefit component will cover hospice election start dates from January 1, 2021 – December 31, 2024,” the Centers [...]
Start preparing for the next phase of the hospice Medicare Advantage carve-in. The Centers for Medicare & Medicaid Services has issued its Calendar Year 2024 Request for Applications for the Value-Based Insurance Design Model’s incorporation of the Medicare hospice benefit. [...]
Don’t make the mistake of thinking you won’t be affected if you don’t operate in one of those counties. Chances are going up that you’ll have to deal with the Medicare managed care’s Value-Based Insurance Design (VBID) Model hospice carve-in [...]
Watch out: Even if a plan doesn’t cover your area, your billing and payments could still be affected. Hospices hoping that Medicare managed care’s Value-Based Insurance Design (VBID) Model hospice carve-in would go away quietly are having those hopes dashed, [...]
Question: Which diagnosis code should I use for an SI joint fracture? Ohio Subscriber Answer: When looking at these types of fractures, you should keep in mind that you can’t have a sacroiliac (SI) joint fracture because you can’t fracture a joint, [...]
Tip: Your best guide is the spinal level. Unlike ICD-9, where you have a single code for reporting cervical fractures with spinal cord lesions., ICD-10 will allow you to report for both the fracture as well as the spinal lesion. [...]
In ICD-10, you look for individual codes for fracture and spinal injury. You need to exercise care when reporting cervical fractures with spinal cord lesions. Whereas ICD-9 has a single code for the two together, you may miss out a [...]
Question: A patient with metastatic carcinoma developed an anterior cord injury along with a pathologic vertebrae fracture. Are we correct to report this with ICD-9 codes 733.13 (Pathological fracture of vertebrae) along with 198.5 (Secondary malignant neoplasm of bone and [...]
Plus: Know how Medicare changed your payment calculations for these services. Bone mass measurement (BMM) has been in the spotlight lately after Medicare once again changed payment calculations for DXA bone density studies. That makes now a great time to [...]
