Connie, the manager of a case management department, was responsible for the patient discharge transportation budget for patients who did not have a ride home from the hospital. Her role covered all medical-surgical units, but not the postacute recovery room (PACU). However, when she received a desperate call from one of the PACU staff nurses, requesting assistance with a patient who did not have a ride home, she agreed to help. Connie viewed her case management department as being service-oriented and inclusive of all patients, even those beyond her assignment.
Whether it is the CPT Manual or Chapter 12 of the Medicare Claims Processing Manual, the definition of a “new patient” is the same for physicians and nonphysician practitioners billing. But that doesn't mean coding and billing for E/M services is clear cut.
This week's note discusses the order and certification requirement for critical access hospitals (CAH), including the proposal in the FY 2018 IPPS proposed rule to reprioritize the review of CAH inpatient admissions.
