Ask the Expert

Q: I've been hearing the term food insecurity increasingly mentioned as it relates to case management. Is there a standard definition for it?

Our experts answer questions about coding drugs infused through the same line, reporting labor and delivery in outpatient hospitals, and more.

Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use ICD-10-CM code Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e., C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?

Our expert answers questions about patient diagnosis codes, same-sex partners, and privacy screens.

Q: What is Medicare's criteria for case-by-case approval of an inpatient stay when the patient is not expected to meet the 2-midnight benchmark?

Q: A patient presents for routine obstetrical (OB) care following a vaginal delivery. During the visit, the provider performs a postpartum depression screening. Should the depression screening be charged separately from the global OB visit service?  

Q. We feel like a nursing staff member may be snooping at another patient’s records—and often. What’s a good first step to take?

Q: I read that CMS changed the scope of work for the Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIO) Livanta and Kepro recently. What impact has that had on hospitals?

Q: Can we bill separately for pulse oximetry?

Q: When a diabetic patient has arteriosclerotic peripheral artery disease (PAD), should an additional ICD-10-CM code be assigned from subcategory I70.2- (atherosclerosis of native arteries of extremities) to describe the affected vessel and laterality?