A recent Office of Inspector General audit estimates that Medicare improperly paid inpatient hospitals $267 million over a two-year period for transfer services incorrectly billed as discharges. Judith Kares, JD , analyzes documentation and billing rules for acute and post-acute transfers.
Approximately 185,000 amputations occur in the U.S. each year, according to the Amputee Coalition. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC , breaks down documentation and ICD-10-PCS coding for amputations of the upper and lower extremities. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS offers hospitals some breathing room to recover from the effects of the COVID-19 pandemic in the 2022 IPPS proposed rule. Review proposed updates to complication/comorbidity (CC) and major CC classifications, and a proposed new MS-DRG rate-setting method aimed at alleviating hospital burden.
In the U.S., tympanostomy tube insertion is the most common ambulatory surgery performed on children under 15, according to StatPearls. Debbie Jones, CPC, CCA , reviews common types of ear infections and CPT coding for myringotomies with tympanostomy tube insertion. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHPC, CHEP, CHC, CICA, CAC, CACO , describes upcoming changes to CMS’ prior authorization program, including expansion of the program to include two additional outpatient services, effective July 1.
CPT codes 63685 and 63688 for spinal neurostimulator procedures have been removed from the list of services that would require Medicare prior authorization when performed in a hospital outpatient department, CMS announced on May 13.
A relatively small 2022 ICD-10-CM update will contain 14 codes of interest to pain management practices if the proposed changes go into effect October 1. Julia Kyles, CPC , unpacks proposed updates to ICD-10-CM codes for painful chronic conditions.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, writes about the spinal conditions that may result in a patient’s need for spinal fusion surgery and outlines how to find the correct ICD-10-PCS code for the procedure.
With the inpatient-only (IPO) list set to be phased out, HIM departments need to prepare for the larger operational and financial impacts. Consider how these changes will affect your organization.
Sarah Nehring, RHIT, CCS, CCDS, examines inpatient procedural coding for pacemaker procedures, as well as taking a look at how coding accuracy for these procedures can impact MS-DRG assignment.
Laura Evans, CPC, and Julia Kyles, CPC, break down potentially confusing updates to the 2021 E/M guidelines, including new definitions for technical terms and revised guidance for reporting diagnostic laboratory testing with interpretation.
Joe Rivet, Esq., CCS-P, CPC, CEMC, CPMA, CICA, CHRC, CHPC, CHEP, CHC, CICA, CAC, CACO, looks at the implications of a recent OIG brief on how Medicare Advantage organizations could use national provider identifiers (NPI) to monitor for fraud, waste, and abuse.
The agency is proposing methods to alleviate burden on hospitals that have been under strain for the past year, while also asking for feedback that may shape future data reporting and rate-setting.
Q: When might it be appropriate to report CPT codes for multiday electroencephalograms (EEG)? In addition, should these codes be billed on the day of initiating or ending the EEG study?
The evolution of the role of clinical documentation integrity (CDI) specialists and their impact on coders has changed the landscape of inpatient coding departments. Learn about how to effectively collaborate with CDI professionals when conducting physician queries.