The Centers for Medicare and Medicaid Services (CMS) began the process of clarifying the level of physician supervision for hospital outpatient services in 2008, continuing with further clarifications and regulatory changes through the CY 2012 outpatient prospective payment system (OPPS) final rule. In this white paper, Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance at HCPro, Inc, in Danvers, MA, will explain the current requirements for supervision of hospital outpatient services, as well as the recent clarification in the CY 2012 final rule.
Modifiers -25 and -59 remain under scrutiny by Recovery Auditors, CMS, and the OIG. Sarah L Goodman, MBA, CHCAF, CPC-H, CCP, FCS, and Susan E. Garrison, CHC, CHCA, PCS, FCS, CCS-P, CPAR, CPC, CPC-H, answer five questions about correct use of modifiers -25 and -59.
Auditing and monitoring, Health information management
The Office for Civil Rights recently published its audit protocol for its current privacy and security audits. These protocols give healthcare organizations an inside look at the inspection process. Our sister publication, Briefings on HIPAA, recently published this breakdown of the audit protocols key activities.
AHA Coding Clinic for ICD-9-CM released its Third and Fourth Quarter 2013 editions of ICD-10 coding guidance, at the close of 2013. As a special supplement to the January edition of the CDI Journal, HCPro CDI Education Director Cheryl Ericson, MS, RN, CCDS, CDIP, discusses information included in the releases.
On January 4, 2013, CMS updated the three-day payment window section of the inpatient chapter of the Claims Processing Manual. Kimberly Anderwood Hoy,JD, CPC, director of Medicare and compliance for HCPro, Inc, in Danvers, Mass, reviews thenew sections which clarify two outstanding questions regarding services in the three-day payment window. She also discusses the update the CPT codes for cardiology procedures considered diagnostic.
Kathy L. Dorale, RHIA, CCS, CCS-P, Susan E. Garrison, CHCA, CHCAS, CHC, CCS-P, CPC, CPC-H, and Monica Lenahan, CCS, provide analysis and commentary on the results of the 2014 JustCoding Salary Survey in this special report.
This 61-page orthopedic superbill includes ICD-10 and CPT codes and descriptions for a variety of orthopedic services. Roberta Bosank-Cera of Hospitals for Special Surgery, New York, NY, submitted the superbill to the Association of Clinical Documentation Improvement Specialists.
When coding guidelines are murky and open for interpretation, coders can sometimes feel as though they're pinned between a rock and a hard place. Discussing the gray areas of coding during a coding roundtable not only helps relieve this tension, but it also helps to establish policies that ensure consistency and continuity. Use this sample charter to build your own coding roundtable.
R.A. Bobrowski, MD, and Lori-Lynne A. Webb,CPC, CCS-P, CCP, CHDA, COBGC, provide operative report examples to distinguish the correct degree of laceration to report during deliveries, according to CPT® and American Congress of Obstetricians and Gynecologists guidelines.
