The novel coronavirus (COVID-19) pandemic has created challenges for case management departments. They must balance protecting the health of case management staff while maximizing productivity. In this new environment, departments are closely examining the role of the utilization review (UR) case manager.
This week's note from the instructor reviews coding and documentation requirements for severe malnutrition in light of another OIG review of these types of claims.
Q: Naturally, companies are curious to learn which of their employees have been exposed to COVID-19 as the workforce begins to return to the office. Under what circumstances can healthcare providers legally disclose a patient’s diagnosis to his or her employer?
An appeals court ruled that CMS has the authority to implement a controversial site-neutral payment policy. The ruling, delivered July 17, reversed a 2019 district court decision that vacated the policy.
This week’s Medicare updates include new FAQ items for COVID-19 billing, updates to the OIG work plan, and another revision to the July 2020 OPPS update.
Q: Patients who leave the hospital against medical advice (AMA) have a much higher 30-day readmission rate than patients with non-AMA discharges. What strategies can case managers use to help patients who may be at risk for leaving AMA?
