Several CPT modifiers have similar definitions, which can make distinguishing between them challenging. Review guidance for the appropriate application of modifier -51 versus -59 and discontinued service modifiers -52, -53, -73, and -74.
CMS finalizing plans to remove the inpatient-only list, only to propose a reversal less than a year later, has introduced challenges for case managers.
In December 2020, CMS announced that it would begin a Review Choice Demonstration (RCD) for inpatient rehabilitation facility (IRF) services. The goal: to improve detection and identification of Medicare fraud related to these services.
Case managers are charged with helping patients to navigate multiple challenges. But sometimes, their own preconceived notions may creep into care interactions and become a barrier.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, breaks down CPT coding for diagnostic services performed during the second and third trimesters, and provides an overview of an obstetric (OB) hospitalist's role in caring for high-risk maternity patients.
