CMS issued a final rule last week reforming the discharge planning process for hospitals, critical access hospitals, and home health agencies that participate in Medicare and Medicaid.
Device-dependent edits require reporting a device code with procedures CMS has designated to be device intensive, and they are meant to ensure that device costs are accounted for in Medicare rates for device-intensive procedures.
As Medicare Advantage makes strides to becoming the new norm, organizations need to establish new processes, educate staff, and advocate for patients. Learn how your organization can keep pace with change before it’s too late to catch up.
Managers should not assume that they can review every guideline, every item in Coding Clinic, or every coding-related issue targeted by the OIG or Recovery Auditors. However, those issues that have been identified as the result of denials, external coding audits, or quality initiatives should surface to the top of the audit list for the coding manager.
Employees need to know what to do and what not to do when it comes to ensuring protected health information (PHI) remains secure. That’s where TeachPrivacy comes in as an excellent resource for quality staff training.
Q: A payer has begun denying authorization for admissions and diverting patients from our hospital to one of our competitors, even when our hospital is closer. Is this a common practice among payers? What language should we add to the contract to discourage it?
