Nursing Management eNews

October 15, 2008

Dear Subscriber,

Be prepared for the new Centers for Medicare & Medicaid mandates with this special CMS edition of Nursing Management's eNews

ISSUE HIGHLIGHTS

	MUEs made available for Part B billing errors
	Conference call series on ICD-10 to be offered
	Deadline for FY 2009 Medicare payment update reconsideration
	Hospitals not paid under OPPS can report on quality measures
	Updated RAC data available
	Outpatient claims with Pap screening code to be held

MUEs made available for Part B billing errors

The CMS has made available most of the Medically Unlikely Edits used by its claims processing software to check for possible billing errors in Part B Medicare claims. More

Conference call series on ICD-10 to be offered

	A series of national conference calls on the ICD-10 coding system used to report healthcare diagnoses and procedures is being offered by the CMS for healthcare providers planning to update to ICD-10 from ICD-9. *More*

Deadline for FY 2009 Medicare payment update reconsideration

Hospitals that received notices that they didn’t meet all the requirements of the quality reporting program and won’t receive a full Medicare payment update in fiscal year 2009 have until November 1 to submit a request for reconsideration to the CMS. More

Hospitals not paid under OPPS can report on quality measures

Critical access hospitals, Maryland hospitals, and other hospitals not paid under the outpatient prospective payment system will be allowed by the CMS to voluntarily report outpatient quality measures for patient encounters beginning January 1. More

Updated RAC data available

The CMS has updated its July 2008 report on the 3-year Recovery Audit Contractor demonstration program, which concluded in March 2008, to show a higher appeals rate on claims denied by RACs through June 30 (19.6% versus 14%) and a higher overturn rate in favor of providers for appealed denials (35% versus 33%). More

Outpatient claims with Pap screening code to be held

Due to a problem with the Outpatient Code Editor software, the CMS is instructing Medicare contractors to hold certain outpatient prospective payment system claims for screening pap smears until January 5, 2009. More

EARN 2.0 CONTACT HOURS

Management CE: The new CMS mandates: Too much, too soon?

Effective October 1, the CMS doesn’t reimburse for eight hospital-acquired conditions. More

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CE: Decrease recovery time with proper pain management
Succession planning: After you, then who?
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