Industry Notes:

Why This Topic Matters

These updates can influence how practices prepare for coverage changes, documentation requirements, claim denials, and contractor medical review activity. Readers who follow Medicare policy and reimbursement operations will want to know which federal and contractor announcements may affect day-to-day billing workflows.

Article Sections

1. Congress to Consider Repeal of Medicare Payments Advisory Board

   A federal legislative proposal and related stakeholder response concerning a Medicare payment oversight board are summarized. The section focuses on broader policy implications for physician payment oversight.

2. CMS Urges Contractors to Add ICD-10 Codes to National Coverage Determinations

   This section addresses CMS guidance to contractors about updating coverage determinations for ICD-10 implementation. It explains the operational significance of aligning coverage policy resources with the new diagnosis code set.

3. CMS Podcast Reminds Practices That Phase 2 Of ‘Ordering/Referring’ Edits Is Coming Soon

   The article reviews CMS communication about upcoming ordering and referring provider edits and related claim processing changes. It highlights the transition period and the need for practices to monitor provider enrollment and claim system data.

4. OIG Quickly Spending Recovery Act Funds

   This brief update reports on HHS Office of Inspector General spending activity related to Recovery Act funds. It provides a snapshot of oversight-related expenditures and timing.

5. Get Ready For Serious Scrutiny Of Your HIPPS Claims

   The final section describes planned Medicare contractor medical review activity for home health claims. It focuses on targeted review activity, affected regions, and documentation follow-up processes.