News & Analysis

December 2, 2019
News & Insights

Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use ICD-10-CM code Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e., C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines again and that is our instruction. Does anyone have experience with this issue?

December 1, 2019
Briefings on APCs

Our experts answer questions about conflicts between coding guidelines and payer requirements, documentation requirements for psychiatric assessments, and more. 

November 27, 2019
News & Insights

Q: I've been hearing the term food insecurity increasingly mentioned as it relates to case management. Is there a standard definition for it?

November 25, 2019
News & Insights

Q: What is Medicare's criteria for case-by-case approval of an inpatient stay when the patient is not expected to meet the 2-midnight benchmark?

November 22, 2019
News & Insights

Q: A patient presents for routine obstetrical (OB) care following a vaginal delivery. During the visit, the provider performs a postpartum depression screening. Should the depression screening be charged separately from the global OB visit service?  

November 21, 2019
News & Insights

Q. We feel like a nursing staff member may be snooping at another patient’s records—and often. What’s a good first step to take?

Pages