This week’s Medicare updates include recommendations on re-opening facilities for non-emergent, non-COVID-19 care, new guidelines for nursing homes on notification of confirmed or suspected COVID-19 cases, a notice about the Accelerated and Advance Payment Programs, and more!
Q: The use of telemedicine and telehealth has expanded dramatically during the COVID-19 pandemic. What should case managers be aware of when determining the most viable telemedicine options for patients?
Coders can raise the flag for the risk management department by signaling unexpected patient care occurrences, such as a nicked organ during surgery. Use this sample occurrence report form as a template for your organization.
Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?
Hospitals, health systems, and long-term care facilities are being challenged by census workers requesting information about patients and residents to conduct an accurate census. Some have gone as far as stating that they have a right to access hospital electronic health records (EHR).
Q: When would you use the ICD-10-CM codes for opioid or marijuana use when no mental, behavioral, or other disorder is connected? I’m specifically thinking of codes F11.90 (opioid use, unspecified, uncomplicated) and F12.90 (cannabis use, unspecified, uncomplicated).
