Ask the Expert

Q: Are there any new HCPCS codes for recently released biosimilar products on the horizon? Our physicians and pharmacists are being contacted by the manufacturer about purchasing and using them, but we want to be sure we can report them appropriately.

Q: How should hospitals report bedside procedures?

Q: If a physician orders a consultation for a patient who is experiencing a headache due to hypertension, which ICD-10-CM codes would be assigned? Would hypertension be coded since headache is a common sign and symptom of hypertension, or would both the headache and hypertension be coded? 

Q: Is there a difference in the documentation requirements for bedside procedures when performed on an inpatient versus outpatient?

Q. What are the requirements for critical access hospitals in relation to the latest proposed Conditions of Participation for discharge planning?

Q: In an outpatient hospital setting, if a patient goes to the floor post-surgery, and the same drugs are continued on the floor, can we charge for their administration? 

Q: How can hospitals set charges for bedside procedures?

Q: You previously talked about drugs with pass-through status beginning in April, but are there any other items with changes in the OPPS update? 

Q: What should the utilization review committee look for when an inpatient stay is less than two midnights?

Q: What should case managers do when a patient lacks decision-making capacity but has no guardian or power of attorney?