Q: If a patient comes into an outpatient facility for a surgical procedure and the physician evaluates the patient before performing the procedure, can you append modifier -25 to the E/M service?
What happens when a patient who requires inpatient rehab care refuses transfer due to concerns about pets staying home alone? This complex case addresses the ways a case manager can handle these tricky situations.
Healthcare providers are often confused about what a commercial or managed care payer would want in order to approve the claim. Much of this confusion comes from the timing of requirements to ensure reimbursement.