Episodios

  • Proposal to Increase CMS Coverage for Immunosuppressive Drugs following Transplants under Part B to Lifetime Coverage

    Proposal to Increase CMS Coverage for Immunosuppressive Drugs following Transplants under Part B to Lifetime Coverage
    May 24 2022
    CMS has proposed that non-disable, under age 65 year old kidney transplants have lifetime coverage under Part B for immunosuppressives instead of the 36-month limit currently.
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    5 m
  • Can Your IT System Report NDC Numbers on Inpatient Claims?

    Can Your IT System Report NDC Numbers on Inpatient Claims?
    May 10 2022
    Whoa! IPPS Proposed Rule includes new process that drugs for NTAP be reported with an NDC number rather than an ICD-10-PCS code. Can your IT system handle this change so you don't lose revenue?
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    4 m
  • IVPB Denials: Clarifying Instructions

    IVPB Denials: Clarifying Instructions
    Apr 26 2022
    Why would an IVPB charge be denied by a payer? In some cases the payer is incorrectly denying the charge. The denial should be clarified and challenged when appropriate.
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    4 m
  • Billing For ESAs

    Billing For ESAs
    Apr 12 2022
    Billing for ESAs on outpatients requires special modifiers and may include laboratory values.
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    6 m
  • The Integrated Outpatient Code Editor (I/OCE)

    The Integrated Outpatient Code Editor (I/OCE)
    Mar 29 2022
    The Integrated Outpatient Code Editor (I/OCE) is a useful quarterly update to help in producing a reimbursable claim.
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    4 m
  • Car T-cell Therapy-Billing and Coverage for Outpatients (Updated)

    Car T-cell Therapy-Billing and Coverage for Outpatients (Updated)
    Mar 15 2022
    Two new HCPCS code and one new product bring the total to six products classified as Car T-cell therapy.
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    3 m
  • If All Else Fails, Submit an Appeal

    If All Else Fails, Submit an Appeal
    Mar 1 2022
    Denied Claims should be reviewed but if the billing is correctly and the service is medically necessary, an appeal is warranted.
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    4 m
  • Convalescent Plasma: New HCPCS Code for Outpatients

    Convalescent Plasma: New HCPCS Code for Outpatients
    Feb 15 2022
    CMS has established a HCPCS code for reimbursement when outpatients receive convalescent plasma.
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    3 m