Part B Payment: CMS Halts Payment for Some Post-Op Infections, Failure to Control Blood Sugar

Article Overview

This article covers CMS’s addition of new Medicare nonpayment categories under the Inpatient Prospective Payment System final rule and the resulting concerns for hospitals, physicians, and coding staff. It focuses on broad categories of hospital-acquired conditions, documentation of present-on-admission status, and the administrative impact on claims processing and reimbursement. The piece is relevant to hospital coders, compliance staff, billing teams, and physicians who work with Medicare payment policy and quality reporting.