Facility evaluation and management (E/M) coding is based on the facility resources utilized to provide medical care. Because CMS has not created national E/M guidelines for emergency department (ED) services, providers must create their own criteria for each visit level. Review your organization’s ED E/M leveling policies to ensure compliance.
Once enforcement of Medicare’s Hospital Readmissions Reduction Program (HRRP) began in 2012, initial data showed hospital readmissions within 30 days of discharge declined for Medicare recipients admitted to hospitals for certain medical conditions. But according to a new study published in The BMJ, the decrease in inpatient readmissions was outpaced by an increase in overall hospital revisits, creating questions about the overall success of the HRRP.
Q: What would be reported as the principal diagnosis if a patient was admitted with both a urinary tract infection (UTI) and sepsis? What would be reported first if the patient developed a catheter-associated UTI with sepsis?
This week's note from the instructor explores proposals from the 2020 Medicare Physician Fee Schedule proposed rule and items for revenue cycle staff to consider commenting on before the comment period closes September 27.
