CMS recently made an administrative settlement process available for inpatient status claims. This process is open to eligible hospitals willing to withdraw pending appeals in exchange for a timely partial payment, or 66% of the net allowable amount, CMS said in the statement.
The 2017 ICD-10-CM Official Guidelines for Coding and Reporting brought many changes and updates for coders, and present-on-admission (POA) reporting was not excluded. Completely understanding POA guidelines is necessary for any inpatient coder.
Q: If a complication is clearly documented as unavoidable or due to a complex situation, should it be coded even if an intervention was done to correct it?
Trey La Charité, MD, FACP, CCDS , notes that getting a handle on a facilities’ case-mix index (CMI) fluctuations can be difficult, and shares insights to how CDI teams can handle these CMI difficulties.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP , writes about how the selection of the code and a principal diagnosis seems fairly straightforward, but there are multiple factors that must be considered and reviewed before a coder can assign a certain diagnosis as principal.
We want your coding and compliance questions! The mission of Coding Q&A is to help you find answers to your urgent coding/compliance questions. To submit your questions, contact Briefings on Coding Compliance Strategies Editor Amanda Tyler at atyler@hcpro.com .
The 30-day all cause acute myocardial infarction (AMI) mortality outcome measure has been linked to hospital payments since the inception of the Hospital Value-Based Purchasing Program (HVBP) in fiscal year 2013. In February 2016, CMS announced that 70% of commercial payers have agreed to use this measure as one of the cardiology outcomes linked to payment.
Jugna Shah, MPH, and Valerie A. Rinkle, MPA, look at comprehensive APC (C-APC) expansion for 2017 and how that will lead to many new codes to be included in C-APCs. They also look at CMS’ new site-neutral payment policies for 2017 included in the latest OPPS final rule.
Q: For the new 2017 epidural injection CPT® codes, the longer-term injections (63234-62327) indicate they are to be used if they are administered on more than a single calendar day. What if we start the administration at 10 p.m. and then discontinue the administration at 1 a.m.? That would be two calendar days. Can we used those codes or should we use the shorter-term injection series (62320-62323)?
