Target audit areas for provider-based department requirements

June 1, 2017
Briefings on APCs

There is an extensive list of coverage requirements that must be met to furnish outpatient ser­vices to Medicare beneficiaries. Hospitals may find that certain coverage requirements for therapeutic and diagnostic service are more difficult to meet than others, especially in off-campus provider-based departments.

Risk adjustment brings CDI efforts to outpatient departments

June 1, 2017
Briefings on APCs

When CMS introduced Hierarchical Condition Categories (HCC) with risk-adjusted scores, Ochsner Health System began efforts to educate providers and improve documentation across its many facilities.

Clarifying CMS' policy for long-term infusions via external pumps

June 1, 2017
Briefings on APCs

CMS issued SE1609 to clarify long-standing policy concerning external infusion pumps. Apparently, both freestanding physician offices and outpatient hospital departments were treating external pumps as an item of durable medical equipment, even when the physician or hospital department set up the pump on the patient, supplied the drug, and programmed the infusion rate and dose into the pump.

This month's coding Q&A

June 1, 2017
Briefings on APCs

The Briefings on APCs experts answer questions about documentation for excisions, changes to recurring payments, and more.