Q: A payer has begun denying authorization for admissions and diverting patients from our hospital to one of our competitors, even when our hospital is closer. Is this a common practice among payers? What language should we add to the contract to discourage it?
Q: The 2020 ICD-10-CM update added several new codes for legal interventions. What are these codes, and can they be assigned based on nonphysician documentation?
Q: Can a healthcare provider be a business associate of another provider? In other words, do providers need to have business associate agreements between one another?
Q: We recently had a patient who was admitted with sepsis and the physician documented sepsis, a urinary tract infection (UTI) related to a chronic Foley catheter, and pneumonia. Can we report sepsis first instead of the complication code, or is the complication always first?
Q: Does the HIPAA Privacy Rule strictly prohibit the disclosure or request of an entire medical record? If not, does there need to be a case-by-case justification every time an entire record is disclosed?
