Many case management directors have questions that arise from time to time on a variety of topics. Here are two such questions along with responses that may help if you’re facing similar challenges.
A case manager works on a postacute transfer plan for a patient who is critically ill with sepsis and at risk for acute renal failure. Because the patient has a history of IV drug use, it is likely that long-term acute care hospitals will deny him admission.
Q: I received confusing guidance regarding CPT coding for a segmental spinal fusion with pedicle screws placed at L3 and L4 vertebrae. Would it be appropriate to report CPT code 22612 with add-on code 22614 for this procedure?
This week's note from the instructor discusses a new exception to the Medicare Secondary Payer Questionnaire process that could reduce the frequency of when these questions need to be asked and enhance patient satisfaction.
Q: How long are we required to retain the records of out-of-state patients? Do we follow HIPAA’s record retention requirements, our state record retention requirements, or the record retention requirements of the state in which the patient lives?
It is critical for providers and any person who is involved with healthcare revenue integrity to stay as current as possible or risk losing out on opportunities to ensure proper and full payment of millions of dollars’ worth of billed and/or billable claims, and the National Association of Healthcare Revenue Integrity’s 2018 Revenue Integrity Symposium can help professionals do just that.
