DURING THE NEXT SIX MONTHS, WE WILL WITNESS an intense debate between the pathology profession and the Medicare/Medicaid bureaucracy. This battle will center around the proposed MUEs (Medically Unbelievable Edits) which place restrictions on the units of service per patient per day on key CPT codes widely used in laboratory medicine.
As you will read in
MEDICARE CODING AND BILLING policies at Tenet Healthcare Corporation have come under scrutiny by both Medicare officials and Wall Street analysts.
Attention is centered around how Tenet aggressively pursued Medicare reimbursement under “outlier” formulas. These formulas are designed to supplement DRG reimbursement when a hospital treats patients with particularly complex health problems.
Huge Jump In Outlier $s
CEO SUMMARY: Events during 1997 reveal that the laboratory industry continues to undergo fundamental change. Yet even amidst the industry’s downsizing, selected laboratory organizations continue to flourish. Here is THE DARK REPORT’s annual look at top stories for the year. A careful analysis of their impact leads to some interesting conclusions.
WHEN FEDERAL REGULATORS introduced a