decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 1 (January)
CMS: No payments for ‘never events’ proposed
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Article Overview
This article summarizes CMS proposed national coverage determinations addressing payment policy for certain surgical errors commonly referred to as “never events.” It explains the scope of procedures discussed, the agency’s rationale, the AMA’s response, and the comment-and-final-rule timeline. The piece is relevant to physicians, coders, compliance staff, and revenue cycle teams working with surgical and invasive procedure claims.
Why This Topic Matters
It highlights a proposed Medicare coverage change that could affect reimbursement, documentation review, and compliance monitoring for certain procedures associated with wrong-patient, wrong-site, or wrong-procedure scenarios.
What You Will Learn
- What CMS proposed regarding payment policy for certain surgical errors
- Which broad categories of procedures are discussed in the proposal
- How the medical association responded to the proposal
- The public comment timeline and expected next steps for CMS
Who Should Read This
- Physicians
- Medical coders
- Compliance professionals
- Revenue cycle staff
- Healthcare administrators
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