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.
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.
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.
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?
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.
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.
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)?
After missing a proposed fall start date, CMS announced last week that its Medicare Part B drug payment model from the Center for Medicare and Medicaid Innovation will not be going forward.
