On May 18, Missouri state legislators approved a law barring insurers from denying emergency department claims based solely on the final diagnosis that the physician assigns to the visit. This move is intended to help those in the state face fewer denials.
The legislation defines "emergency medical condition" as "the sudden and, at the time, unexpected onset of a health condition that manifests itself by symptoms of sufficient severity, regardless of the final diagnosis that is given, that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that immediate medical care is required...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: