Ask the Expert

Q: How do we determine if a patient’s pneumonia is community acquired or not? What documentation should we look for to support this?

How can hospitals gain the support of the chief executive officer for revenue cycle team efforts?

How can discharge planners collect discharge planning data? What type of software supports data collection?

Q: We are a critical access hospital and don’t get paid under the OPPS. We get reimbursed based on our cost of procedures, tests and services. Is modifier –JW (drug amount discarded/not administered to any patient) applicable to us beginning in January?

Who should lead a facility’s revenue cycle plan?

What categories should a patient’s final discharge plan include?

Q: Coding Clinic, Third Quarter 2011, p. 4 states:

“…morbid obesity is a chronic condition and; therefore, can be coded as a secondary diagnosis without treatment.” (emphasis added)

An article in the CDI Journal, “From the Forum: Manage denials for BMI morbid obesity,” seems to indicate that providers should document how the obesity affects patient care.

What level of patient care needs to be documented?

What factors indicate that an observation stay would be covered?