Hospital outpatient

Providers know the drill for addressing and operationalizing CMS' annual IPPS and OPPS updates, along with the usual ICD-9-CM and CPT® coding changes. The industry has become used to CMS' timetable for releasing inpatient and outpatient proposed and final rules and knows that it has to be ready to go live with coding, billing, and operational changes October 1 and January 1, respectively.

Adding modifiers to CPT ® codes can bypass NCCI edits for Medicare payments, but they're often misapplied.

Our coding experts answer your questions about observation orders, sequencing additional diagnoses, coding for wound care with no-cost skin substitute, and reporting cardiac rehabilitation and physical therapy together.

Hospitals received a timely reminder about the importance of properly setting charges in CMS' 2012 OPPS final rule.

Our experts answer questions about reporting myocardial infarctions in ICD-10-CM, documentation for orthopedic procedures, and more.

Get ready for more packaged services, including laboratory tests and add-on codes, if CMS finalizes changes proposed in the 2014 OPPS proposed rule.

Coding for observation services can be confusing and complicated. Review these three case studies to determine how well you know observation coding.

"Sometimes the questions are complicated and the answers are simple." ?Dr. Seuss This quote seemed an appropriate way to begin a discussion about outpatient encounters and ICD-10-PCS. You see, outpatient procedures will still be coded using CPT ® /HCPCS?the HIPAA-approved code set for reporting hospital outpatient procedures?regardless of when ICD-10 is implemented.

How does CPT ® define “final examination” for code 99238 (hospital discharge day management; 30 minutes or less

CMS corrected edit 84, added five APCs to the I/OCE, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. In addition, CMS deleted all of the genetic testing modifiers, retroactive to January 1.