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
Anesthesiologists: Physicians providing the lifeline of modern medicine. Founded in 1905, the American Society of Anesthesiologists is an educational, research and scientific association with 46,000 members organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists Web site at www.asahq.org. For patient information, visit LifeLineToModernMedicine.com
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