Editor's note: The following scenario is provided by Laurie A. Rinehart-Thompson, JD, RHIA, CHP, assistant professor of clinical allied medicine in the School of Allied Medical Professions at Ohio State University in Columbus. Present the scenario portion to your HIM staff to see how they would handle the issue.
Coding accuracy in postoperative complications impacts a facility's Medicare claims profile, error rate, and physician profiles on hospital watchdog websites that monitor performance.
Our coding experts answer your questions about coding for hysteroscopy prior to ablation, appending modifier -59 for MRI and MRA, charging for venipunctures, therapy caps under OPPS, reporting limits for Provenge®, modifier -59 and infusion therapy, Reporting TEE pre- and post-operativley, coding for toxic metabolic encephalopathy
When the AMA revised the instructions for reporting ancillary services with critical care in 2011, facilities knew they wouldn't see an immediate increase in payment. CMS determines payment amounts through use of claims data from two years earlier, meaning the earliest facilities could expect additional reimbursement is 2013.
