Website: http://www.hcpro.com

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10 selected articles

HCPro: Providing Information to the Healthcare Compliance ...

Medicare Managed Care Appeals & Grievances

Plans and providers have certain responsibilities related to notifying beneficiaries of Medicare...

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Reimbursement for Facility and Professional Services in a ...

Reimbursement for Facility and Professional Services in a Provider-Based Department by Gina M. Reese, Esq., RN

Medicare Insider, September 8, 2015

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Services furnished in a provider-based department are generally billed in two or more claims--so-called split billing. A portion of the payment is made for the claim...

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Healthcare Accreditation - Hospital Accreditation, Joint ...

Spotlight

The CMS Compliance Crosswalk

The latest incarnation of HCPro's renowned and respected accreditation crosswalk provides the next generation in healthcare standards compliance. This new...

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Related topics : centers for medicare and medicaid services cms / centers for medicare & medicaid services cms / center for medicare medicaid services / centers for medicare & medicaid services / cms center for medicare medicaid

Billing for observation - www.hcpro.com

Q. A consulting company instructed our facility that we cannot bill observation charges to Medicare with revenue code 762 even when we don't expect additional payment. One example is when a patient requires prolonged stay after a procedure. We have been charging an observation bed charge under revenue code 762 with CPT 99218. We would like your opinion on this issue.

A. Based upon your specific...

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Related topics : medicare billing observation services / medicare observation services / medicare revenue codes / medicare hospital manual / medicare covered services

Note from the instructor: Billing Outpatient Laboratory ...

Note from the instructor: Billing Outpatient Laboratory Services - TOB 131 vs. TOB 141

Medicare Insider, March 4, 2014

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This week's note from the instructor is written by Debbie Mackaman, RHIA, CHCO, regulatory specialist for HCPro, Inc.

Since the implementation of the calendar year (CY) 2014 Outpatient...

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Related topics : medicare billing lab services / medicare hospital bills / centers for medicare and medicaid services cms / centers for medicare & medicaid services cms / medicare billing bundled services

Inpatient-only procedures: Accuracy helps avoid denials ...

Inpatient-only procedures: Accuracy helps avoid denials, ensure compliance

JustCoding News: Inpatient, October 10, 2012

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Inpatient-only procedures are those that CMS has determined providers must perform on an inpatient basis because they are invasive and require at least 24 hours of postoperative...

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Related topics : medicare procedure codes for billing / medicare procedure codes and modifiers / cms hhs gov medicare / cms medicare manual chapter 4 / fee for service providers medicare

Note from Peggy: Out with the old purchased services and ...

Medicare Update for Physician Services, February 4, 2010

Say good-bye to purchased diagnostic tests and purchased test interpretations. And say hello to its new, concise replacement: anti-markup tests.

 

CMS released a transmittal on January 15 that updates the Medicare Claims Processing Manual regarding anti-markup limitation rules. To understand everything, it's helpful to have a terminology...

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Related topics : billing medicare for purchased services / medicare purchased diagnostic services / medicare billing service / medicare fee for service schedule / medicare purchased services

Clearing up the confusion: CPT codes 76376 and 76377 - www ...

If determining whether to bill for two-dimensional (2D) or three-dimensional (3D) reconstructions wasn't confusing enough, the American Medical Association (AMA) deleted code 76375 and introduced two new codes to describe 3D rendering in 2006.

The new codes are

76376 —3D rendering with interpretation and reporting of CT, magnetic resonance imaging (MRI), ultrasound, or other tomographic...

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Related topics : medicare physician fee schedule data base / 2006 medicare physician fee schedule / physician medicare fee schedule / medicare provider fee schedule / medicare procedure codes for billing

The CMS Conditions of Participation and Interpretive, 2018 ...

Compliance with the Conditions of Participation (CoP) is required to meet Medicare and Medicaid hospital regulations. While CMS posts updates to the CoPs on its website, they are often difficult to search and lengthy, not to mention tedious to print.

This is where HCPro comes in! We have taken the most recent version of CMS' CoPs and the corresponding Interpretive Guidelines (IG) and reprinted them in an easy-to-use...

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Related topics : medicare and medicaid conditions of participation / hospital medicare conditions of participation / medicare hospital regulations / cms medicaid medicare

Q/A: Billing outpatients for dialysis in inpatient unit ...

Dialysis performed following or in connection with a dialysis-related procedure such as vascular access procedure or blood transfusions

Dialysis performed following treatment for an unrelated medical emergency; e.g., if a patient goes to the emergency room for chest pains and misses a regularly scheduled dialysis treatment that cannot be rescheduled, CMS allows the...

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Related topics : medicare inpatient dialysis billing / medicare dialysis billing / medicare hospital bills / cms medicare provider