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.
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.
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.
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.
A room and board policy defines routine daily hospital services and covered medical and surgical services and supplies. Use this sample policy as a template for your organization.
