CMS Issues Information About Never Events

Chicago — (September 25, 2009) 

Effective Jan. 15, 2009, the Centers for Medicare and Medicaid Services (CMS) does not cover surgical or invasive procedures necessary to treat medical conditions when the practitioner erroneously performs:

  • A different procedure altogether;
  • The correct procedure but on the wrong body part; or
  • The correct procedure but on the wrong patient.

For inpatient claims, hospitals are required to submit a no-pay claim when the erroneous procedure is reported.  Two claims should be submitted when there are covered services/procedures provided during the same stay as the erroneous surgery but unrelated to the erroneous surgery.  For outpatient and practitioner claims, providers are required to append the applicable HCPCS modifiers to all lines related to the erroneous procedure.

CMS has issued additional information about “never event” scenarios.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 50,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGYTM 2013 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES2013.

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Contact:

American Society of Anesthesiologists
communications@asahq.org
847-825-5586