Q: If a patient is seen for a pressure ulcer on the foot related to diabetes, would you report a diabetes diagnosis code? If surgical debridement is performed and the patient receives treatment for their diabetes, can you charge for both an office visit and debridement?
Affording prescription drugs can be a challenge for many patients. Even for patients with insurance, cost sharing and copays can add up. To head off these potential problems, case managers are often tasked with identifying affordability issues and finding solutions for patients to help ensure they can comply with discharge recommendations.
This week's note from the instructor is the second article in a series reviewing the coverage, billing, and payment rules for swing bed services. This edition of the series focuses on professional services related to swing beds as well as applicable billing and payment rules for swing beds in critical access hospitals (CAH) and non-CAH small rural hospitals.
Success under MACRA relies on the capture and maintenance of trustworthy clinical and financial patient data sets. HIM professionals understand root cause analysis, the mechanism of reporting data, and the importance of data consistency and integrity.
Q: I work for a hospital with a geriatric psychiatry unit. Many patients are discharged to nursing homes. Often, nursing homes contact the hospital for patient information, but we have only the patients' psychiatric records and are hesitant to send them. Is it permissible under HIPAA to send this information to a nursing home for continued care?
This week’s Medicare updates include proposed rules for the FY 2019 Skilled Nursing Facility Prospective Payment System (PPS), Inpatient Rehabilitation Facility PPS, Inpatient Psychiatric Facility PPS, and Hospice Wage Index and Payment Rate Update; the quarterly listing of Medicare program issuances; a guide on multi-payer model requests for advanced APM determinations; and more!
