CMS proposed that a new HCPCS modifier be appended to every code for a service furnished in a hospital's off-campus provider-based department on both the CMS-1500 claim form for physicians' services and the UB-04 form (CMS Form 1450) for hospital outpatient services in the 2015 OPPS proposed rule. Despite many detailed comments opposing this change, no consensus emerged; therefore, CMS is moving forward with implementing a slightly modified policy.
In a concerted effort to move healthcare payments to a system of "quality over quantity," CMS finalized policies that greatly expanded packaging for outpatient providers in the 2015 OPPS final rule. It also introduced complexity adjustments with comprehensive APCs (C-APCs).
Q: If someone calls a facility to schedule an appointment for a patient, is it a violation of HIPAA to admit the patient receives care at the practice? For example, the practice where I work often helps victims of domestic abuse. We received a call from a patient's estranged spouse who asked to schedule an appointment for the patient when, in reality, he was trying to determine the whereabouts of his spouse so he could harm her. I realize this is a safety issue but wonder whether it is also a HIPAA issue.
Many coders rely on the advice in the American Hospital Association (AHA)'s Coding Clinic to resolve sticky situations with ICD-9-CM coding. However, the AHA will not be transitioning its current guidance to ICD-10-CM. Instead, in January, it began focusing solely on ICD-10-CM questions to help clear up confusion prior to implementation.
Mobile devices have changed the way people share and access information in their personal and professional lives. Smartphones and tablets may make it easier and faster for people to communicate, store, and access information, but they present risks if lost, stolen, or hacked. This can be especially challenging in the healthcare industry as it has become common for providers to use various mobile tools, including smartphones, laptops, notebooks, tablets, phablets, personal digital assistants, USB devices, digital cameras, and radiofrequency identification devices, to communicate with colleagues and access applications.
