Ask the Expert

Q: How do Medically Unlikely Edits (MUE) apply to clinical trials claims?

Q: When patients transfer to long-term care or skilled nursing facilities, they have basic information with them, but what questions should those facilities ask to make sure they have all the information they need to provide care?

Q: I’m new to coding and am having trouble understanding how to find the correct MS-DRG for a patient. Could you walk me through the process?

Q: What is the difference between "consent" and "authorization" under the HIPAA Privacy Rule?

Our experts answer questions about reporting E/M services along with drug administration, dealing with pre-payment denials, and more.  

Q: What language can we add to our contracts to discourage payers from diverting patients to other hospitals based solely on cost?

Q: What new CPT codes for urinary procedures did the American Medical Association introduce for calendar year 2019?

In this month's HIPAA Q&A, our expert answers questions on shared insurance policies, posting thank-you notes in employee-only areas, referrals to Part 2 facilities, and more!

Case managers often run into questions when performing their daily duties. Sometimes they’re related to best practice, and other times they’re related to regulatory issues.

Q: We had a patient with hemorrhagic cystitis. Our preprocedural plan was a cystoscopy with a bladder biopsy and cauterization. How should this be reported in ICD-10-PCS? We are having trouble choosing between Control or another root operation, and we are getting different MS-DRGs depending how the procedure is reported.