Facility evaluation and management (E/M) coding is based on the facility resources utilized to provide medical care. Because CMS has not created national E/M guidelines for emergency department (ED) services, providers must create their own criteria for each visit level. Review your organization’s ED E/M leveling policies to ensure compliance.
The Office of Inspector General (OIG) will review Medicare’s diagnosis-related group (DRG) window policy to determine whether the program could save money by expanding the policy to include more days, according to an update to the OIG Work Plan.
This week’s Medicare updates include a Special Edition MLN Matters article on the new documentation requirements for cost reports, revised manual instructions related to the implementation of the Patient-Driven Groupings Model, an OIG review of the impact of price substitutions based on average sales price data, and more!
Once enforcement of Medicare’s Hospital Readmissions Reduction Program (HRRP) began in 2012, initial data showed hospital readmissions within 30 days of discharge declined for Medicare recipients admitted to hospitals for certain medical conditions. But according to a new study published in The BMJ, the decrease in inpatient readmissions was outpaced by an increase in overall hospital revisits, creating questions about the overall success of the HRRP.
