This week's note from the instructor discusses the new appropriate use criteria reporting requirements for providers ordering advanced diagnostic imaging services in 2020.
Healthcare providers are using ICD-10-CM Z codes at an increasing rate to document social determinants of health (SDoH), according to a new report from CMS.
A large HIPAA breach settlement after a hospital system’s alleged failure to follow the feds’ suggested solution is a reminder that when it comes to enforcement, the government is holding all the cards.
Several Medicare claims for trastuzumab mutli-dose vials billed over the last three years failed to comply with Medicare requirements in part due to the improper application of modifier -JW, according to a study reported in the January 2020 Medicare Quarterly Provider Compliance Newsletter.
Q: How do we bill for services when our utilization review (UR) team determines postdischarge that an inpatient admission was not medically necessary? Are these services billed as outpatient or inpatient?
Q: We are finding that physician documentation is lacking for vaping-related lung injuries at our hospital, making it hard to report the condition accurately. What can our coding team do to remedy this situation, and how do we accurately report vaping-related lung injuries in ICD-10-CM?
Case manager discharge planners, get ready: Another challenge awaits us in 2020. Beside the new Medicare discharge planning rule, more changes were made to Medicare Advantage (MA) plans.
This week's note from the instructor discusses the new appropriate use criteria reporting requirements for providers ordering advanced diagnostic imaging services in 2020.
Q: In OCR's $3 million settlement with Touchstone Medical Imaging, one of Touchtone's FTP servers allowed uncontrolled access to patients’ PHI. This permitted search engines to index the PHI of patients, which remained visible even after the server was taken offline. What missteps can providers avoid in this arena?
Q: My organization is interested in starting a program to address food insecurity among patients in our community. What factors should we consider when forming the program?
This week’s Medicare updates include a new addition to the OIG work plan, the January edition of the Medicare Quarterly Compliance Newsletter, the January 2020 update to the Outpatient Prospective Payment System, and more!
Conflicting provider documentation can raise red flags for auditors and slow down coding. Learn about common causes of conflicting documentation and strategies to reduce its occurrence.
The 340B drug discount program does not appear to incentivize hospitals to use more expensive drugs, according a Medicare Payment Advisory Commission (MedPAC) report presented at its January 17 meeting.
