Case managers often run into questions when performing their daily duties. Sometimes they’re related to best practice, and other times they’re related to regulatory issues.
Q: We had a patient with hemorrhagic cystitis. Our preprocedural plan was a cystoscopy with a bladder biopsy and cauterization. How should this be reported in ICD-10-PCS? We are having trouble choosing between Control or another root operation, and we are getting different MS-DRGs depending how the procedure is reported.
Q: I recently filed a complaint against my insurance company. The insurance agent who handles my case informed my boss that I filed a complaint against her. Now my boss is mad at me, and I feel like my job is at risk. Is this a HIPAA violation?
