Hospital outpatient

Our experts answer questions on cyst excisions, observation timing, MUEs, and more.

Medical necessity denials traditionally focus on high-dollar DRGs, such as those for hip and knee replacements; others may also soon become targets.

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

When CMS introduced the -X{EPSU} modifiers in August 2014 to be used in specific instances to replace modifier -59 (distinct procedural service), the agency encouraged "rapid migration" to the new modifiers.

Because of the increase in the number and type of outpatient services provided, more patients are being impacted by noncoverage of self-administered drugs. Kimberly Hoy, JD, CPC, and Valerie Rinkle, MPA, explain why CMS sometimes--but not always--covers self-administered drugs.

Our experts answer questions about injections and infusions, edits for flushing a line, and coding for irradiated blood products.

Most coding professionals have heard modifier -59 (distinct procedural service) referred to as a modifier of last resort and to be cautious in using this modifier.

Our experts answer questions about modifier -52 application, infusion coding, and more.

Coders can find the largest number of new codes in the pathology and laboratory section of the 2012 CPT® Manual . The AMA added a total of 103 new codes, 101 of which denote Tier 1 and Tier 2 molecular path-ology procedures.

The 2016 OPPS proposed rule released July 2 is deceptively short, but packs a punch. CMS is proposing the most massive APC reconfiguration and consolidation of APC groups since the beginning of OPPS, says Jugna Shah, MPH, president and founder of Nimitt Consulting, based in Washington, D.C., and Spicer, Minnesota.