The year 2021 ushers in significant and crucially important changes to the Medicare program that will impact reporting implantable medical device credits and managing patient accounts when such devices are billed. Also during 2021, the types and numbers of devices that must be reported with credits has ballooned due to the gradual plan to eliminate the Inpatient-Only List as well as recent “threshold qualifier” changes. With many more devices to monitor, there are more credits to assess and more patient accounts to manage, potentially resulting in more errors.
Medical device credits continue to be an easy mark for governmental auditors, and now a new favorite of auditors included in the OIG Annual Work Plan is the target area of outlier payments related to implantable medical device credits in the outpatient space. You might not even be aware you’ve received these payments and are at risk!
Learn how to save your facility hundreds of thousands of dollars in potential repayments and fines by correctly following Centers for Medicare & Medicaid Services (CMS) requirements for these targeted services.
Why This is Relevant:
A favorite target area for various federal auditing entities including individual Medicare Administrative Contractors (MACs), is the reporting of medical device credits which continues to be an easy mark for governmental auditors. A ballooning number of device credits in the outpatient setting, plus a new OIG target, means facilities could be at increased risk for fines and penalties related to device credits in 2021.
- Identify which devices get reported when a credit is received and how to correctly report the credits in hospital inpatient, outpatient and ASC settings
- Understand the mandatory implantable medical device credit reporting and how to uncover a little-known target area, a new favorite of the OIG
- Gain a better understanding of the rules for initially-placed (not replacement) implantable devices, which device credits are reported in this category, and the proper way to report CC-53
- Learn how to perform due-diligence reviews of the newest and related area of OIG scrutiny for devices: outpatient outlier payments
- Gain a “how-to” for ASC reporting including device credit modifiers, targeted devices and common errors!
Who Should Attend:
C-suite executives; HIM directors, coding managers, staff and billers; revenue cycle personnel including directors, managers and billers; revenue integrity analysts; compliance officers and specialists; auditors; operating room directors and managers; cardiac cath lab and invasive cardiology directors and managers; vascular lab directors and managers; interventional radiology directors and managers; neurosurgical personnel; and ASC directors.
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