Q: A physician performed a pleural catheter flush using saline with manual clearance of clots under ultrasound guidance. Should we bill an E/M code for an outpatient office visit or report this using other CPT codes?
Q: The Office for Civil Righs (OCR) has settled its first case related to its Right of Access initiative. What is important to know about this from a security standpoint? Where are common security missteps with releasing information to patients upon request?
HHS’ Health Resources and Services Administration (HRSA) should step up oversight of hospitals participating in the 340B drug discount program, the U.S. Government Accountability Office (GAO) recommended in a recent report.
This week’s Medicare updates include a Special Edition MLN Matters article on appropriate use criteria changes, updates to beneficiary notice forms, a beta version of an ICD-10-CM browsing tool, and more!
Take a look at some common questions asked about MS-DRG optimization and review how inpatient coding and documentation plays a significant role in the process. Learning the ins and outs of this process will ensure that your facility remains educated and compliant.
Q: What is the process for submitting a claim for an inpatient hospitalization when our utilization review committee determined after discharge that the inpatient admission was not medically necessary?
Findings from a December Office of Inspector General (OIG) report show that CMS based an estimated $2.7 billion in risk-adjusted payments on chart review diagnoses that Medicare Advantage organizations (MAO) didn’t link to specific services. Their findings highlight concerns about the validity of payment data submitted to CMS.
Q: Our coding department was told there were changes made for fiscal year (FY) 2020 when it comes to reporting healed/healing pressure ulcers and pressure-induced deep tissue damage. Can you explain any recent updates?