COUMADIN CLINICBILLINGAND REIMBURSEMENT

- CoaguChek PSTSystem

- CoaguChek PSTStrips

- CoaguChek Controls

- Alcohol swabs

- Lancets

- Lancing device

- Software for analysis and reporting of test results

G0249 and G0250 may be billed only once for every four tests However, CMShas assigned a Medically Unlikely Edit (MUE) or 3 for G0249, therefore hospitals may report up to 3 units of G0249 on one claim, which allows coverage of up to 12 tests. The service is billable on a date when a patient would attend the clinic for a face to face visit

If a Coumadin Clinic is enrolled with Medicare as an Independent Diagnostic Testing Facility (IDTF), only codes G0248 and G0249 may be billed as technical components.

An IDTFcannot provide the professional component (G0250).Most Coumadin Clinics are enrolled as departments of a hospital or under a Medical Group enrollment, however.

When physician-directed, diagnostic services are rendered from an outpatient hospital clinic, the services are reimbursed under the payment guidelines of CMSOPPS.

This payment system affects which codes can be billed and how they will be paid

CorroHealt h invit es you t o check out t he m lnconnect s page available from t he Cent ers For Medicare and Medicaid (CMS) It 's chock full of new s and inform at ion, t raining opport unit ies, event s and m ore! Each w eek PARA w ill bring you t he lat est new s and links t o available resources Click each link for t he PDF!

Thursday, August 10, 2023

New s

- Immunization: Protect Your Patients

Claim s, Pricers, & Codes

- Outpatient Rehabilitation Claims with Reason Code W7072: Do You Need to Resubmit Claims?

MLN Mat t ers®Art icles

- HCPCSCodes Used for Skilled Nursing Facility Consolidated Billing

Enforcement: October 2023 Update

Publicat ions

- Expanded Home Health Value-Based Purchasing Model: New Resource & Updated FAQs

Mult im edia

- Skilled Nursing Facility: Minimum Data Set Resident Assessment Instrument Training Materials