For case managers, some of the most challenging patients are those with multiple chronic conditions, and ensuring effective care and preventing avoidable readmissions requires coordination, communication, and consistent follow-up.
In the 2018 OPPS final rule, CMS removed total knee arthroplasty (TKA) from the inpatient-only (IPO) list effective January 1, 2018. Although some guidance was provided at the time, providers and physicians alike were left confused with a significant number of questions regarding documentation and inpatient status
Coding for knee arthroscopies can be challenging, especially when procedures are performed in multiple compartments of the same knee. Read about anatomy and coding details required to accurately report these procedures.
Many outpatient CDI professionals stepped into their roles blind—not knowing where to begin or how to tell if they were successful. However, as programs mature, they need to be able to track their progress for a number of reasons, including focusing physician education and justifying continued funding from organizational leadership.
A case manager returns to work at the start of the new year only to find that two of his patients’ commercial insurances had implemented new discharge planning and utilization review rules effective January 1.
