Hospitals

CMS has recently updated all sections of the hospital-acquired conditions and the present-on-admission indicator reporting Web site to describe the changes published in the CMS IPPS fiscal year 2009 final rule. [PERL 200809-33, 200809-41, 200809-43]

Instructions revising payment under OPPS for implanted prosthetic devices furnished to Medicare beneficiaries who, on the date the device is implanted, are hospital inpatients without Part A coverage of services, but with Part B coverage. [MM6050]

CMS has extended the previous instructions to fiscal intermediaries about holding hospital claims with HCPCS Q0091 for dates of service on or after April 1, 2008, until changes to the shared system are implemented on January 5, 2009. [JSM 08465]

CMS has revised the implementation date of change request 6185 to December 1, 2008. In addition, the transmittal numbers, CR release date, and the Web addresses for accessing CR 6185 were revised. All other information remains the same. [MM6185]

This is an update on the issue in which outpatient claims (TOB 13x) rejected as duplicates of an inpatient claim previously denied by the RAC when services provided did not support admission into an inpatient stay.

CMS has identified an issue regarding payment for off-label drug usage for the anti-cancer and anti-emetic drugs. Manual review of the affected clams is being performed until the implementation of the October 2008 quarterly release. [JSM 08439]

Due to systems issues related to an incorrect deductible and coinsurance assignment for HCPCS code Q0091, contractors will hold claims for screening Pap smears until the OCE version scheduled for implementation on January 5, 2009. [PERL 200809-03]

CMS identifies teaching hospitals by an intern-to-bed ratio greater than zero. The Medicare contractors may contact the method II critical access hospitals to obtain their intern-to-bed ratio and update the records on the provider specific file. [MM6176]

The Hospital Compare Web site gives consumers an insight into the quality of care provided by their local hospitals. Hospital Compare has become a popular tool for consumers and their caregivers in making health care decisions. [PERL 200808-32]

CMS revised this MLN Matters article on August 19, 2008, to correct the effective date, which should have been stated as August 1, 2008, NOT April 1, 2008. All other information remains unchanged. [MM5849]

As of May 5, 2008, acute care hospitals paid under the inpatient prospective payment system and inpatient rehabilitation facilities may elect to use either the fiscal year 2005 or FY 2006 supplemental security income ratio. [MM6126]

The latest version of fact sheets for federally qualified health centers, Medicare disproportionate share hospitals, and the inpatient psychiatric facility prospective payment system have been updated and posted to the CMS Web site. [PERL 200808-09]

The latest version of the inpatient rehabilitation facility PPS PC PRICER software has been updated and posted to the CMS Web site on August 4, 2008. You may download the latest version at your convenience. [PERL 200808-09]

The latest version of the inpatient PPS PC PRICER software has been updated and posted to the CMS Web site on August 8, 2008. You may download the latest version as your convenience. [PERL 200808-07]

HCPCS code Q4096 is payable on inpatient claims effective April 1, 2008. The appropriate systems changes for editing Q4096 on inpatient claims will be made in the FISS on January 5, 2009. [MM6006]

CMS is required to update the payments made under the Long Term Care Hospital Prospective Payment System (LTCH PPS) annually. Payments are made on a per discharge basis, using long-term care diagnosis-related groups (LTC-DRGs). [MM6114]

This fact sheet provides valuable information related to critical access hospitals (CAH) that includes CAH providers, designation, and payments. [PERL 200807-15]

CMS has amended previous instructions regarding inpatient denials identified by a recovery audit contractor to include type of bill 13x for any services provided on the inpatient bill that could be billed as outpatient. [JSM 08168]