Throughout the years, this column has focused on the important role the electronic document management system (EDMS) plays as the official legal health record (LHR) within a healthcare organization, and especially as a critical workflow tool for the HIM department. I am always surprised to hear that there are still some facilities that haven't figured this out and purchased an EDMS.
Conducting pre-billing audits can be challenging, but when done correctly, it can save organizations from spending time recoding and rebilling claims that payers deny. These audits can be conducted on the front end, in both inpatient and outpatient settings, once records have been coded.
Lately I've received a lot of questions from hospitals about how to determine when and if it's appropriate to report an E/M visit code on the same date of service as a scheduled procedure.
Most coding professionals have heard modifier -59 (distinct procedural service) referred to as a modifier of last resort and to be cautious in using this modifier.
In an effort to accommodate the latest advances in technology and make the code set easier to modify for future technological changes, the AMA extensively overhauled codes for reporting drug testing in the 2015 CPT® Manual.
Mergers and acquisitions in the healthcare industry are often decided upon and negotiated by C-suite staff with involvement from security and IT professionals. However, significant security implications must be considered by both parties prior to, during, and after a merger or acquisition.
