Q We're struggling with nursing documentation of stop times for IV infusions (e.g., piggybacks and hydration). The nurses also inconsistently document a patient's return to the unit from diagnostics. We know that CMS now allows us to use average times for common services, and we're interested in considering this approach at my organization. Can you share additional specifics?
In total, the AMA added 60 new codes throughout the surgery section of the 2012 CPT® Manual , 18 of which appear in the cardiovascular and respiratory system subsections. The AMA also revised 86 codes and deleted 48 codes in the surgery section.
Perhaps you're familiar with the following scenario: A hospital submits a short-stay inpatient (Part A) claim. An auditor, such as a RAC or MAC, reviews the claim and deems the admission to be not reasonable and necessary due to the hospital billing the wrong setting. The auditor issues a denial for the full amount of the claim. Although the hospital may rebill for certain Part B ancillary services before the timely filing limit, it may not bill for any of the other outpatient services denied as part of the inpatient claim.
In total, the AMA added 60 new codes throughout the surgery section of the 2012 CPT® Manual , 18 of which appear in the cardiovascular and respiratory system subsections. The AMA also revised 86 codes and deleted 48 codes in the surgery section.
Perhaps you're familiar with the following scenario: A hospital submits a short-stay inpatient (Part A) claim. An auditor, such as a RAC or MAC, reviews the claim and deems the admission to be not reasonable and necessary due to the hospital billing the wrong setting. The auditor issues a denial for the full amount of the claim. Although the hospital may rebill for certain Part B ancillary services before the timely filing limit, it may not bill for any of the other outpatient services denied as part of the inpatient claim.
QUESTION: A physician admits a 30-year-old male with lower abdominal pain. A CT scan showed consistency with perforated appendicitis. However, the patient had an appendectomy 10 months prior. The physician documents "appendiceal stump syndrome." How should I code this case?
The only thing we have to fear is fear itself, according to Franklin D. Roosevelt. We certainly shouldn’t fear the transition to ICD-10-CM/PCS. Unfortunately, however, it seems to be a common...
Physicians use devices all the time during procedures. For example, they may place a temporary catheter in a patient, insert a drug-eluting stent, or insert a central line. So when do you report a...
Coders who are preparing for the upcoming transition to ICD-10-CM should note some significant changes to the coding guidelines for glaucoma coding as part of the 2012 updates to the ICD-10-CM Official Guidelines for Coding and Reporting .
We hear about physician engagement across and throughout all healthcare settings almost daily, so it’s nothing new. But it's important for the upcoming transition to ICD-10-CM/PCS. Gloryanne Bryant, RHIA, RHIT, CCS, CCDS, offers suggestions for how to get your physicians engaged in the change.
As hospitals develop more intensive training programs for ICD-10-CM/PCS, coordinators may want to consider how different learning styles will impact the effectiveness of these training sessions. Education has to work for everyone and one size does not necessarily fit all. Victoria Weinert, RHIT, CCS and Lora Ma explain how to get everyone moving in the same direction and prevent coders from going rogue.
Coders will need more information to correctly assign fracture codes in ICD-10-CM, but don’t fear. Most of that information is already in the medical record. Robert S. Gold, MD, Sandy Nicholson, MA, RHIA, and Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, walk through what you need to know to code fractures in ICD-10-CM
When you hear the word 'transplant', what do you think of first? Many people probably think of organ transplants. If you’re one of those people, you’re all set for the ICD-10-PCS root operation...
Have you heard that not all payers will be ready for the ICD-10-CM/PCS coding system on October 1, 2013? What a headache, huh? All payers were required to be ANSI X12 Version 5010 compliant by...
Times are changing, and, most likely, so are the jobs of your health information management (HIM) staff members. In some cases, there's a sudden addition of responsibilities, such as the implementation of the recovery audit contractor program. In other cases, the increased use of technology triggers a shift. If these changes aren't managed appropriately, you may end up with declines in performance, careless errors, low productivity, or diminished quality. Elizabeth Layman, PhD, RHIA, CCS, FAHIMA, shares her approach to HIM department and job restructuring.
The Office of the Inspector General (OIG) stated in its recent publication, “Hospital Incident Reporting Systems Do Not Capture Most Patient Harm,” that a series of reports examining adverse events in hospitals shows that for the hospitals it surveyed, the incident reporting systems only tracked approximately 14% of incidents.
