With a new year underway, providers likely need to get a handle on some key new modifiers, as well as important changes to an existing modifier and the deletion of a modifier that previously raised a lot of questions and operational concerns.
Pneumonia discharges impact hospital payments under the Hospital Value-Based Purchasing Program as well as the Hospital Readmissions Reduction Program. The selection of a principal diagnosis, secondary diagnosis, present on admission (POA) status, and discharge status on each claim determines whether a pneumonia discharge will be included in the measure.
The Office for Civil Rights (OCR) released guidance on patient access fees with little fanfare last year but the guidance, intended to clarify existing OCR regulations, became a flashpoint for controversy. The guidance states that organizations may charge a patient either a flat fee of $6.50 or follow a specific methodology for calculating the cost of making a copy of requested patient records. Although some organizations found their fee schedules out of step with OCR’s guidance, the biggest problem came from an unexpected corner: attorneys.
Inpatient coding departments are likely familiar with integrating clinical documentation improvement (CDI) specialists into their processes. Crystal Stalter, CPC, CCS-P, CDIP, looks at how CDI techniques can benefit outpatient settings and what services and codes facilities should target.
