Case managers today have many demands placed on them, from meeting patient needs to ensuring quality, reducing legal risks, and ensuring that care is efficient and cost-effective. In a new HCPro book, Case Management Models: Best Practices for Health Systems and ACOs, Second Edition, author Karen Zander, RN, MS, CMAC, FAAN, tackles numerous topics, focusing on how to structure case management models across the continuum of care.
Q: Is CPT code 96416 (chemotherapy administration requiring use of portable pump) the same as HCPCS code G0498 (initiation of infusion of chemotherapy in office using portable pump)? Our facility is trying to determine if it would be appropriate to set up G0498 as a Medicare override for 96416.
Q: What information can safely be imprinted on a nursing home resident’s wristband (for going out to a doctor appointment or other activity such as a baseball game)? We would like to provide enough information for emergency or safety purposes but not enough to put one at risk for ID theft.
The specificity of ICD-10 ushered in a stronger focus on clinical coding audits. From internal reviews to external coding audits, healthcare organizations nationwide are revisiting tried-and-true audit practices with ICD-10 coding quality in mind.
An emerging case management model involving fourth-generation patient-centered care coordination may help address the shortcomings of traditional case management models, especially in high-risk populations, according to a Phoenix Medical Management, Inc., article.
This week's Medicare updates include the 2018 Inpatient Psychiatric Facilities Prospective Payment System Update; Revisions to the Home Health Pricer to Support Value-Based Purchasing and Payment Standardization; Quarterly Update to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS); and more!