“Outpatient” does not equate “same-day.” By this time last year, the Centers for Medicare & Medicaid Services (CMS) had notified providers that they were removing total knee arthroplasty (TKA) from the Medicare inpatient-only list. While the cries of disbelief and howls of frustration eventually died down after a few months,…
This week we are going to flash back a few years. Our first stop is in 2011, when First Coast Services Organization, the Medicare Administrative Contractor (MAC) for Florida, Puerto Rico, and the Virgin Islands, denied 92 percent of all claims for total joint replacement in an audit for lack…