The April 2013 issue of CMS’ Medicare Quarterly Provider Compliance Newsletter highlights two Comprehensive Error Rate Testing (CERT) issues that affect outpatient providers.
Anesthesia coding in some ways is similar to evaluation and management coding—only easier. Chandra Stephenson, CPC, CPC-H, CPMA, CPC-I, CANPC, CEMC, CFPC, CGSC, CIMC, COSC, explained the 10 steps to coding anesthesia during the AAPC National Conference in Orlando, Fla., April 14-17.
Don't let underpayments fly under the radar Nearly 75% of participating hospitals nationwide with RA activity reported receiving at least one underpayment determination, according to the AHA...
The three-day payment window has been wrought with compliance challenges since its inception. In January, CMS updated the policy to provide additional clarification.
William E. Haik, MD, FCCP, CDIP, a practicing pulmonologist and director of DRG Review, Inc., in Fort Walton Beach, Fla., says he first became interested in coded data in 1986 after a local newspaper published his hospital’s costs, length of stay, and mortality rates for simple pneumonia. At the time, he was the only pulmonologist in the local area. The patients he treated were often those with multiple comorbidities as well as gram-negative bacterial pneumonia who had been transferred from two smaller facilities in the county.
In this month's issue, we examine CMS' Part A to Part B rebilling ruling and proposed rule, look at how facilities are being reimbursement for the new molecular pathology codes, review changes to the I/OCE for April, and answer your questions.
CMS corrected edit 84, added five APCs, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. Dave Fee, MBA, reviews the most significant changes CMS implemented
According to the Centers for Disease Control and Prevention, 31% of all American adults have high blood pressure, so odds are coders see the condition documented often. Shelley C. Safian, PhD, CCS-P, CPC-H, CPC-I, AHIMA-Approved ICD-10-CM/PCS Trainer , compares coding for hypertension in ICD-9-CM and ICD-10-CM.
Q: If a patient has a spinal deformity on L5-S1 and we use the appropriate codes from 2280X and then the physician performs an arthrodesis/fusion on the same level, can we bill the appropriate fusion codes (225XX-226XX) as well? My impression is no, but I would love to get some insight into this question.
When coders begin using ICD-10-PCS the second and fourth character definitions seem simple enough: Second character-Body system Fourth character-Body part However, when coders start assigning codes,...
You know what keeps you up at night thinking about the ICD-10 transition. Have you ever wondered what causes CMS officials to lose sleep? For Denise Buenning, MsM, director of CMS’s administrative...
It was almost inevitable. The possibility of another ICD-10 delay was brought up during the AHIMA ICD-10-CM/PCS and CAC Summit in Baltimore April 24. And just as quickly as it was raised, the...
DRGs for procedures unrelated to the principal diagnosis should occur rarely. Robert S. Gold, MD, and Cheryl Ericson, MS, RN, CCDS, CDIP, explain when it is appropriate to report an unrelated DRG.
Distinguishing between clinical and coding significance is often confusing. Joel Moorhead, MD, PhD, CPC, discusses how coders should differentiate between the two.
The three-day rule defines certain preadmission outpatient services as inpatient operating costs that are covered and paid under the IPPS. Kimberly Anderwood Hoy, JD, CPC, and Valerie A. Rinkle, MPA, unravel the complex conditions associated with the rule.
I wanted to share some interesting numbers from Torrey Barnhouse's presentation at the AHIMA ICD-10 Summit in Baltimore. Torrey is the founder and president of TrustHCS, which conducted an industry...
Trust is a basic human emotion. It allows us to explore out surroundings and grow. You can't expect grouth or change without trust. Cindy Seel, MSA, RHIA, director of education and training at HRS,...
Any healthcare organizations are considering computer-assisted coding (CAC) to help minimize the expected coder productivity decline in ICD-10. Lisa Knowles-Ward, RHIT, coding and reimbursement for...
