The Business of Medicine Blog
In the past month, we have blogged on the following topics:
CMS Approves Three National Organizations to Accredit Suppliers of Advanced Imaging Services - CMS sent out the following information in a news release yesterday. The requirements for qualifying as a ’supervising physician’ remain open to debate lacking specific guidance from CMS. Should CMS require the ’supervising physician’ to be a ‘board-certified Diagnostic Radiologist,’ this will affect many in-office imaging services, such as MRI.
Accreditation Required for Office-Based Procedures (Indiana) - A new requirement is in place as of the first of this year requiring office-based accreditation for procedures requiring certain levels of sedation/anesthesia. This mostly impacts pain procedures, GI and cosmetic done in the office. Anything involving a major nerve block up to full anesthesia is included.
CMS Rescinds Place of Service/Date of Service Changes - Good news for radiology groups struggling to comply with date overlap (date of test versus date of interpretation) and place of service (test in hospital, read somewhere else). The Centers for Medicare & Medicaid Services (CMS) announced on February 5, that it has rescinded Change Request (CR) 6375, Transmittal 1873 sent via RO-6657, dated December 11, 2009, and will replace it with another CR in the future, pending further policy clarification on date of service and place of service reporting for the interpretation of diagnostic tests.
Medicare Claims Crossover to Supplemental Payer Problem - In a message sent out by CMS on February 16, they announced that action is required by some health care providers to receive supplemental payment. Included in their statement, "The Centers for Medicare & Medicaid Services (CMS) has identified a problem where claims were not automatically crossing over to supplemental payers even though the provider remittance advice indicated otherwise. This problem began January 5, 2010. Part A institutional claims and Part B professional claims, with the exception of supplier claims processed by Durable Medical Equipment Medicare Administrative Contractors (DME MACs), were impacted by this problem. Claims processed by DME MACs were not impacted."
Update on Claims Processing for Ordering/Referring Providers - CMS continues to urge physicians and non-physician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 to update their enrollment record now. If these physicians and non-physician practitioners have no changes to their enrollment data, they need to submit an initial enrollment application which will establish a current enrollment record in PECOS.
Read the full posts on our blog...
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