Facilities Articles and Resources
News and Important InformationFind-A-Code's Tools & ResourcesFacility NCCI Edits ValidatorValidate using NCCI edits for errors in code selection. ASC Topic PageAmbulatory Surgical Center Links and Resources APC Topic PageAmbulatory Payment Classifications Links and Resources Global Period/DaysGlobal Period/Days Additional Links and ResourcesGuidelines & ManualsResearch Links and Resources by Category Medicare Claim ReviewMedicare Claim Review Programs NewslettersNewsletters and Articles Part B Hospital BillingCh. 4 Medicare Claims Processing Manual Billing Requirements for OPPSProviders with Multiple Service Locations HCUP Inpatient Payer DataHCUP - Healthcare Cost and Utilization Project Noridian: Quick Reference Billing GuideNoridian: Quick Reference Billing Guide Outpatient Facility FeesUCR Section VA Table F Nationwide charges v3.27 (January-December 2020) Case Mix Calculation ExampleCMI – Case Mix index Reporting of Revenue Codes Under the OPPSReporting of Revenue Codes Under the Outpatient Prospective Payment System (OPPS LocationsCritical Access HospitalsCritical Access Hospitals Fees, Designations, Etc. Noridian: ASC ResourcesNoridian JE Part B Ambulatory Surgical Center (ASC) Resources Hospital Outpatient Regulations and NoticesHospital Outpatient Regulations and Notices Long-Term Care Hospital PPSLong-Term Care Hospital Prospective Payment System Provider Based Facilities- CMSOwned and operated by single entities referred to as "main providers." Ch. 5 Medicare Claims Processing ManualPart B Outpatient Rehabilitation and CORF/OPT Services Select the title to see a summary and a link to the full article. June 23rd, 2022 Why You Should Be Using The Two-Midnight RulePublished June 23rd, 2022 |Are you using something other than two-midnight? Here’s why you shouldn’t be. Is there the possibility that your utilization management team and physician advisors are applying InterQual, MCG, or any other utilization tool other than the two-midnight rule to your Medicare admissions? Over the last few months, it has... June 14th, 2022 Using Health IT to Support Safer Use and Management of Controlled Substance PrescriptionsPublished June 14th, 2022 |New ONC data show that, as of 2021, nearly all non-federal acute care hospitals were enabled to electronically prescribe controlled substances (EPCS). According to the American Hospital Association (AHA) Information Technology (IT) Supplement Survey, the proportion of non-federal acute care hospitals enabled for EPCS increased from 67% in... June 9th, 2022 The Nuances of the Two-Midnight RulePublished June 9th, 2022 |When is a patient an inpatient? A reader we’ll call Michelle asked a question during a recent Monitor Mondays broadcast — a question that encapsulated many of them: how can a Medicare patient who stays two midnights for a non-medical reason be an inpatient? For example, consider a... October 28th, 2021 Understanding ASCs and APCs: Indicators and Place of ServicePublished October 28th, 2021 |The decision regarding the most appropriate care setting for a given surgical procedure is determined by the physician based on the patient's individual clinical needs and preferences. Of course, there is a difference in reimbursement, and the billing depends on where the procedure took place, such as an office setting, inpatient ... May 25th, 2021 PCS Coding for Ankle Fracture - Look Deeper Into the Codes!Published May 25th, 2021 |If you're looking for ankle fractures in ICD-10-PCS, you may need to look a little deeper. Let's take a look at coding an ankle fracture such as a trimalleolar fracture. PCS coding can be confusing as it is nothing like CPT coding; with CPT we can simply code an ankle ... May 3rd, 2021 UB-04 Claim FormPublished May 3rd, 2021 |The UB-04 Claim Form, also known as CMS-1450, is used for submitting claims for reimbursement for specially designated facilities. The 837i is the electronic version of the form. Much like the 1500 Claim Form, maintained by the National Uniform Claim Committee, the UB-04 Claim Form is maintained by the National Uniform Billing Committee (NUBC) which maintains lists of approved codes used on various fields on the form (e.g., revenue codes, condition codes). Third-party payers, including Medicare, may have their own adaptations of the general instructions published by the NUBC. There are more articles. View all articles... View articles for the current subject by subtopic: (There are no webinars at this time, please check back later.) |
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