Medicare does not treat all surgeries the same. An inpatient-only surgery list is released every year by CMS. These procedures are automatically approved for Part A coverage and must be performed in a hospital. All other surgeries, as long as there are no complications, are covered by Part B.

CMS also releases an annual Addendum AA that specifies what outpatient (i.e. not inpatient-only) procedures can be performed in Ambulatory Surgery Centers. All remaining outpatient surgeries must be performed in a hospital for anyone on Medicare.

Find out which group your procedure falls into ahead of time so that you can better plan for it and avoid additional stress. Today’s episode will help us tackle error resolutions together.

Also, Terry will review X-Modifier information for revenue integrity!

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