decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 3 (March)
New rule: CMS won’t pay for ‘never events’
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Article Overview
This article covers CMS’s final National Coverage Determinations addressing selected preventable surgical errors commonly called “never events.” It is relevant to coders, compliance staff, and billing professionals who need to understand the policy scope, the related ICD-9-CM diagnosis code request, and where CMS says appeals and related coverage guidance are addressed.
Why This Topic Matters
The article matters because it describes a Medicare noncoverage policy that can affect claim payment, retrospective recoupment risk, and documentation and appeals handling for affected services.
What You Will Learn
- Which broad categories of surgical errors CMS addressed in its final national coverage policy
- How the article connects Medicare noncoverage policy with coding updates and tracking efforts
- Where the article says additional guidance on appeals and related services can be found
- What kinds of procedures CMS discusses as potentially within the scope of the policy
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Revenue cycle professionals
- Healthcare administrators
- Physician practices
Codes Discussed
Code Ranges Discussed
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