decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 2 (February)
CMS: No pay for ‘never events’ proposed
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Article Overview
This article discusses proposed CMS national coverage determinations related to payment for certain preventable surgical errors commonly described as “never events.” It explains the general scope of the proposal, the types of procedures CMS says are included or excluded, the timing of the draft decisions, and the AMA’s stated concerns. The piece is relevant to coding, compliance, and reimbursement professionals who track federal coverage policy and procedure classification issues.
Why This Topic Matters
It highlights a proposed Medicare coverage policy affecting how certain surgical and invasive procedures may be reviewed for payment, making it important for providers, coders, and compliance teams monitoring CMS policy changes.
What You Will Learn
- The general scope of CMS’s proposed coverage policy for certain surgical errors
- Which broad categories of procedures CMS says are affected or excluded
- How CMS and the AMA differ in their view of the proposal
- Where to find the referenced CMS draft decision memos
Who Should Read This
- Medical coders
- Compliance officers
- Revenue cycle staff
- Physicians and surgeons
- Healthcare administrators
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