Medicare and other providers have increased scrutiny of modifier 25, and the Office of the Inspector General (OIG) has identified it as a potential area of overuse or misuse, thereby increasing the possibility of audits. Here's what you need to know.
Last week, we discussed the “Site-Neutral Rule,” which would reduce Evaluation and Management charges for off-campus outpatient programs, including wound care and hyperbaric medicine centers. This week, 38 Hospitals sued Health and Human Services (HHS), challenging the rule. The lawsuit alleges that HHS Secretary Alex Azar exceeded his authority when this rule was implemented January 1, 2019.
The OIG released the results of a MAC audit report on Hyperbaric Oxygen Therapy (HBOT) services. Based on the sample charts, they estimated there were over $39 million in HBOT overpayments for the sample year alone in this jurisdiction.
Fall brings vibrant colors, homemade chili, championship baseball – and new CMS regulations for reimbursement! In reviewing upcoming changes for 2018, here are five takeaways that wound centers need to be aware of.