HIM professionals are being challenged like never before. By focusing on practical steps, closely monitoring official guidance, and embracing flexibility, they can stay on top of their duties.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O, reviews the latest guidance and ICD-10-CM reporting for common novel coronavirus (COVID-19) scenarios such as reporting for patients who present for testing with symptoms of COVID-19.
CMS released a new interim final rule with comment period that grants organizations another round of flexibilities to meet the challenges of the COVID-19 public health emergency, including permitting hospitals to bill for telehealth services and loosening restrictions on COVID-19 testing.
Modifier -22 indicates that the procedural work performed by the provider or surgeon was substantially greater than what is typically required. The application of this modifier allows providers to receive additional reimbursement for a procedural service that was especially challenging, time-consuming, or unusual.
Coders can raise the flag for the risk management department by signaling unexpected patient care occurrences, such as a nicked organ during surgery. Use this sample occurrence report form as a template for your organization.
Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?