This week's instructor note dives into the recent instruction from CMS on requirements for reporting a COVID-19 diagnosis on a claim in order for the claim to be eligible for a payment increase.
Q: If a person has a history of substance abuse, but at the time of admission appears to be of sound mind, is that patient’s personal representative still entitled to receive information about the patient’s treatment and status?
Determining which denials could be overturned on appeal is key to a successful denial management program. Learn how to leverage your appeal team's knowledge to create a data-driven scoring system.
Finding the right applicant to fill a vacancy in the coding department can be challenging. Organizations can help close the gap and improve their coding staff by implementing an apprentice program. Use this sample education schedule to help develop a program at your organization.
CMS extended the education and operations testing period for the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging through 2021. The education and operations testing period, which started January 1, 2020, was slated to close at the end of the year.
Q: As utilization review case managers, we are often tasked with assessing our hospital's risk for novel coronavirus (COVID-19) denials. What are the most important measures we should be examining?
