Shelley C. Safian, PhD, RHIA, CCS-P, writes that inpatient Removals of a device from a lower bone may be performed less frequently than other procedures, which creates a need for more education on reporting ICD-10-PCS codes from table 0QP. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Pediatric record reviews require a different skill set than those in the traditional adult acute care space. Often, those reviewing these specialized charts are islands within their overall CDI or coding department, acting as the sole pediatric chart reviewer. This article sheds light on how some have perfected these reviews within their department.
Judith L. Kares, JD, reviews potential updates found in the fiscal year (FY) 2022 IPPS proposed rule that pertain to quality programs for inpatient hospitals and changes to address existing inequities in the delivery of these services.
In April, CMS released the fiscal year (FY) 2022 IPPS proposed rule. The rule contains proposed payment changes under Medicare Part A for covered inpatient stays in short-term acute care hospitals and inpatient stays in long-term care hospitals.
Approximately 34.2 million Americans, or 10.5% of the U.S. population, were diagnosed with diabetes in 2018, according to the Centers for Disease Control and Prevention. Review signs and symptoms of diabetes mellitus types 1 and 2 and ICD-10-CM coding for these conditions.
National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) can throw a wrench in the Medicare billing process, delaying appropriate revenue. Learn how to apply recent guidance and best practices to resolve challenging edits.
Refresh your knowledge of dysphagia, esophagitis, gastroesophageal reflux disease, and Barrett’s esophagus, and review guidance for reporting these conditions in ICD-10-CM.
Joe Rivet, Esq, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , summarizes findings from recent Office of Inspector General audits that highlight improper billing of high-level inpatient stays. He also outlines steps hospitals can take to prevent billing errors due to upcoding.
Medicare Recovery Auditors will review claims submitted by inpatient psychiatric facilities to ensure that billed services are medically reasonable and necessary, according to a recent Medicare Quarterly Provider Compliance Newsletter.
Howard Rodenberg, MD, MPH, CCDS , describes how internal reviews can be used to identify repeated coding errors and prevent payment penalties due to Patient Safety Indicators (PSI) and hospital-acquired conditions (HAC).
Approximately 1.5% of the general population sees a primary care physician each year for treatment of chest pain symptoms, according to Family Practice . In this article, Sarah Nehring, RHIT, CCS, CCDS , breaks down potentially confusing ICD-10-CM coding guidelines for chest pain and angina. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CPT coding for psychotherapy and psychiatric diagnostic evaluations can be challenging, especially when these services are provided with office visits. Shelley C. Safian, PhD, RHIA, CCS-P , breaks down documentation and CPT coding for visit services provided with psychiatric care. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medicare waivers and flexibilities allow providers to deliver care via telecommunication technology during the COVID-19 public health emergency (PHE). Judith Kares, JD , reviews CPT coding for e-visits, virtual communication services, and telephone E/M services.
CMS withdrew the split/shared and critical care sections of the Medicare Claims Processing Manual and announced its intent to update coverage policies for these services. Prepare for changes to come by reviewing documentation, CPT coding, and billing guidance for split/shared and critical care services.
University of Michigan Health System overcharged Medicare an estimated $12.5k for polysomnography services submitted over a two-year period, according to a recent Office of Inspector General (OIG) report. Overpayments were due to insufficient documentation and CPT coding errors.
