Hospital systems need to be watchful for CMS proposals that will impact payment for drugs and drug therapies in 2019 and beyond. Jugna Shah, MPH, reviews the potential implications of recent CMS actions, such as the publication of the 2019 IPPS proposed rule and the overhaul of 340B drug payment program.
Cognitive impairment ranges from mild to severe and can impact a person’s ability to perform everyday functions such as talking, remembering, and comprehending information. Debbie Jones, CPC, CCA , reviews CPT and ICD-10-CM coding, and care planning for patients living with cognitive impairment.
To help bring JustCoding members together and let them learn more about their colleagues, JustCoding created a monthly member spotlight to appear in upcoming issues. The JustCoding team loves hearing members’ stories, including major triumphs and challenges, and sharing them with the larger JustCoding membership.
Inpatient coding audits are performed for different purposes by individuals within and outside of the hospital. Coding audits can be categorized in various ways as shown below, but these attributes are not exclusive: Audits will have several characteristics at a time.
Predicting CMS policies can be a foolhardy exercise, especially with a relatively new administration and frequent turnover at the highest levels of HHS over the last year. But it’s safe to say drug payment policy has been and will continue to be a focus of the current regime.
Healthcare providers are often confused about what a commercial or managed care payer would want in order to approve the claim. Much of this confusion comes from the timing of requirements to ensure reimbursement.
Coders are on the front lines of claim submission and in a good position to foster compliance. Learn strategies to prevent fraud and abuse and encourage accurate documentation and billing within your outpatient facility. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: If a patient comes into an outpatient facility for a surgical procedure and the physician evaluates the patient before performing the procedure, can you append modifier -25 to the E/M service?
