Explant Management: Device Warranty Credit Calculation and Coding Resolution
CMS requires hospitals to pursue and report the replacement of an implanted device due to a defect or recall. Included in CMS rules, hospitals must:
- Return any warranty credits to Medicare that are at least 50% of the cost of the replacement device
- Adjust the value and condition coding for all qualified procedures to ensure reimbursements are reduced
If not in compliance, hospitals are at risk for substantial financial penalties. The average OIG fine is $400k, but can reach the millions.
Watch a short video to learn more about CMS requirements and how automating explant management can reduce risk in an OIG audit, minimize financial penalties, and increase warranty credits that are retained by your hospital.
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