Modifiers provide a means by which a physician or facility can flag a service that has been altered by a special circumstance but has not changed in definition or code. Break down CPT guidelines for reporting hospital modifiers -25, -50, -59, -LT, and RT.
CMS' new final rule prepares for vaccine coverage for Medicare, Medicaid, and commercial insurers without any out-of-pocket costs. CMS will pay for any coronavirus vaccine that receives FDA authorization either through an Emergency Use Authorization or via a license under a Biologics License Application.
The HIM department plays a critical role in the revenue cycle, but it’s often placed in a reactive position, limiting its effectiveness. Learn how to improve operations by enhancing the HIM department’s involvement across the revenue cycle.
I received a note from Diane Matysik, a CDI supervisor for Ascension Health in Duluth, Minnesota, who asked a question near and dear to my emergency department (ED) heart: If a patient suffers an out-of-hospital cardiac arrest and is resuscitated before arrival in the ED, should the scenario be described with an ICD-10-CM Z code?
One concern CDI professionals and inpatient coders say they struggle with is physician engagement and education. Without an engaged physician staff, CDI and coding efforts will languish with unanswered queries and subpar documentation practices.
Alicia Kutzer, Esq., LL.M., M.H.A , reviews CMS’ Interim Final Rule with Request for Comments (IFC) concerning coverage, billing, and payment for COVID-19 vaccines and therapeutics. This guidance is imperative for inpatient hospitals to evaluate to ensure proper documentation and reimbursement.
Sarah A. Nehring, RHIT, CCS, CCDS, details ICD-10-CM reporting and clinical indicators for hepatic fibrosis, cirrhosis, and complications caused by cirrhosis such as ascites and spontaneous bacterial peritonitis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The Office of Inspector General (OIG) recently announced it plans to audit hospital inpatient claims. According to the report, the OIG wants to determine if inpatient claims with short lengths of stay were incorrectly billed as inpatient when they should have been billed as outpatient or outpatient with observation.
Q: We have an elderly patient admitted to our hospital who is also presenting with osteoarthritis (OA) of the right knee. How can we determine primary versus secondary OA, and how would it be reported in ICD-10-CM?
The American Medical Association (AMA) on November 10 announced a handful of new CPT codes for reporting COVID-19 vaccine products and immunization administration.
A multi-organizational collaborative is proving further evidence of the growing interest in behavioral health integration with primary care. Read about organizational efforts to improve collaboration between primary care and mental health providers and enhance billing for behavioral health services.
ICD-10-CM coding for genitourinary conditions requires careful attention to detail. Learn about genitourinary structures and their functions as well as new ICD-10-CM codes for glomerulonephritis, chronic kidney disease, and granulomatous mastitis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, RHIT, CCS, CCDS , details three significant changes to the ICD-10-CM tabular list Excludes notes that may prove valuable to hospitals in fiscal year (FY) 2021, including updates to Excludes notes for encephalopathy, toxic encephalopathy, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
