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CMS Will Run Medicare Claims with ICD-10 Codes Through 'End-to-End' Testing
The CMS will offer end-to-end testing of Medicare claims using the ICD-10 diagnostic and procedure codes, an attempt to deliver much sought-after assurances that its contractors will be prepared for the Oct. 1 implementation date.
The CMS will offer “end-to-end” testing of Medicare claims using the ICD-10 diagnostic and procedure codes, an attempt to deliver much sought-after assurances that its contractors will be prepared for the Oct. 1 implementation date.
The testing will allow the participating providers and suppliers to submit test claims to the CMS with ICD-10 codes and receive a remittance advice explaining how the claims were processed, according to the CMS.
The goals are to demonstrate that providers or other submitters, such as claims clearinghouses, are able to successfully send claims containing ICD-10 codes to the Medicare fee-for-service claim systems; that CMS' software changes made to support ICD-10 result in appropriately adjudicated claims, based on the pricing data used for testing purposes; and that an accurate remittance advice is produced.
Read the full story here: http://bit.ly/1eXGAQ5
Source: Modern Healthcare
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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Antismoking groups sued the US government over the long-awaited menthol cigarette ban; the fill rate for Adderall and Vyvanse dropped more than 10% in 2 years despite soaring demand; the Biden administration has responded to offers from the manufacturers of drugs selected for Medicare pricing negotiations.
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CMS released a final rule to help patients obtain Children’s Health Insurance Program (CHIP) coverage and issued a proposed rule to update Medicare payment policies and rates for inpatient rehabilitation facilities; debate over if gift card incentives are acceptable in health care marketing.
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