HOSPITALS: Note These OPPS Changes To Avoid Future Trouble

Why This Topic Matters

These changes can affect whether a hospital claim is paid correctly under OPPS and whether services are reported in the appropriate setting. Understanding the update helps facilities reduce denials and stay aligned with Medicare outpatient billing requirements.

Article Sections

1. Observation reporting updates

   Overview of changes affecting outpatient observation payment and the type of information facilities need to keep in mind when reporting these services.

2. G0244 gets new descriptor

   Discussion of the revised observation-related code entry and the general effect of the update on reporting requirements.

3. Observation timing considerations

   General explanation of when observation time starts and ends, along with a note about longer observation stays and related E/M reporting considerations.

4. Mammographies are out

   Summary of the OPPS payment change affecting mammography services and the shift to a different Medicare payment system.