Outpatient Surgery Magazine - Subscribers

The Economics of Prefilled Syringes - August 2017 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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side, wrong patient, wrong procedure, wrong implant; hospital transfer/admission; and prophylactic IV antibiotic timing. ASCs that don't meet program requirements may receive a 2% reduction in ASC payment updates. While some facilities have ensured that they report these 5 claims- based measures by setting internal billing systems to auto-populate the 2 default codes to all CMS claims, there is no oversight to ensure accu- racy if and when an event does occur. In some cases, CMS claims are routinely billed with the 2 default codes unless and until the billing office is verbally instructed otherwise. On the flip side, some ASCs aren't meeting the program minimal reporting requirements and are now being hit with a 2% reduction in Medicare payments. The verifica- tion of these quality measures is a clinical function, not a billing func- tion. The last entry before discharge should be to review and verify these measures. How do you do so? Speak to your software vendor about adding a drop-down menu for all applicable claims-based quality measures that must be reviewed and checked off before clinical chart- ing is deemed complete. Failing to self-audit. Fraudulent billing practices can go unno- ticed if you or a central business office or billing company fail to conduct weekly/monthly internal audits of all aspects of the revenue cycle. OSM Ms. Bentin (cristina@ccmpro.com) is the president of Coding Compliance Management in Baton Rouge, La., which helps surgery centers manage their coding, education and audit programs. 10 A U G U S T 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 2 9

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