Learn how to save your facility hundreds of thousands of dollars in repayments and fines by correctly following CMS requirements for implantable medical device credit reporting. We provide you with all the need-to-know protocols, along with the steps for correct compliance while offering best practices to implement a viable strategy in your facility.
Implantable medical device credits, a favorite target area for the OIG and RACs, ZPICs, CERT and the individual MACs, continue to be an area of potential risk for providers and an easy mark for federal auditors. Ongoing scrutiny only promises to intensify as auditing entities have laid plans to continue to target this error-filled area in 2023.
With the ever-expanding list of implantable devices, the chance for mistakes, oversights and inappropriate billing associated with device credits is greater than ever. Add to this, the “seesawing” of the CMS “Inpatient-only List” with hundreds of procedures being dropped and then added back, has led to confusion when those procedures include devices needing to be monitored, tracked, and reported by different operational teams. Recently expanded OIG audits for device credits are also targeting APC outlier payments directly related to reported device credits and Value Code “FD,” resulting in large repayment provider obligations.
Michael G. Calahan, PA, MBA, Certified Compliance Officer, will teach you how to identify, track and manage these credits, how to report them correctly, and how to implement steps for avoiding errors. He will discuss how to avoid the newly extended area of OIG focus, the APC outlier payments directly related to reported device credits and Value Code “FD” and cover the lesser-known clinical scenario of implantable medical device credits with initially-placed implantable devices (usually during clinical trials) and the mandated Condition Code 53, and ultimately empower you to take steps to prevent repayments and fines.
Auditors of all kinds view the reporting of implantable device credits as low-hanging fruit. Heading into 2023 they are planning to continue efforts to rectify improper payments. In addition, they’ll be aggressively pursuing the recoupment of inappropriate outlier payments for outpatient device procedures. It’s imperative to make sure your organization is fully complying with all CMS requirements and following best practices for device credit reporting.
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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