In the January 11, 2018 issue of MLN Connects, CMS has now widely publicized that it issued billing guidance for major joint replacements (hip or knee) in May 2017 at ICN909065.
CMS reports that major joint replacement is one of Medicare’s top volume DRGs and, that due to the high volume of these claims, CMS has had multiple auditing entities (RAC, CERT, and other recovery auditors) review claims for these DRGs. That guidance is attached or available as follows:
Link: https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Downloads/2018-01-11-eNews.pdf
Click here to read the 1/11/18 Issue of MLN Connects