HCPro, JustCoding Inpatient - 2019 Issue 8 (February)
Healthcare News: CMS releases fix for organ acquisition overpayments
February 19th, 2019
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Article Overview
This news item explains a CMS update aimed at preventing certain organ acquisition charges from being included in inpatient payment calculations when claims group to non-transplant Medicare severity DRGs. It is relevant to hospital billing staff, transplant program administrators, and Medicare claims processors who follow CMS and MAC guidance. The article also notes a subsequent CMS revision addressing specified revenue codes and updates to the change request details.
Why This Topic Matters
The topic matters because it affects how inpatient claims are processed and how organ acquisition-related charges are treated in Medicare payment workflows. Hospitals and contractors need to understand the scope of the CMS change and the revised guidance to avoid processing errors and payment discrepancies.
What You Will Learn
- What CMS changed in its inpatient claims processing approach for organ acquisition charges
- Which broad categories of claims are affected by the update
- How the article frames the role of MLN Matters and Medicare contractor processing
- What later CMS revision elements were noted in the editor’s note
Who Should Read This
- Hospital billing and coding staff
- Medicare claims processors
- Transplant center administrators
- Revenue cycle professionals
- Compliance teams
Code Ranges Discussed
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