Q: We are confused on the reporting of HCPCS code C9399 (unclassified drugs or biologicals) for new diagnostic radiopharmaceuticals and contrast agents that are approved by the FDA but don’t yet have a HCPCS code. CMS guidance states that this HCPCS code should be used until a specific HCPCS code for the item has been assigned, but we have one that is going on two years and there is not a new HCPCS code assigned yet. When we ask about it, the answers have varied.
What drives specific elements of revenue cycle management with respect to discharge planning in hospitals? Discharge planners’ role in improving the revenue cycle is more proactive than reactive. This means that what discharge planners do during a patient’s hospital stay and how they document it will help the patient accounts department submit a claim likely to be paid without being audited.
This week's note from the instructor concludes our discussion on multiple notices that hospitals and critical access hospitals (CAH) are required to provide to outpatients and inpatients in particular situations. The focus this week will be on streamlining hospital notification processes to avoid the necessity of recreating the wheel each time a new notice requirement is implemented.
This week’s Medicare updates include an OIG report regarding hospital noncompliance with Medicare Requirements for billing outpatient right heart catheterizations with heart biopsies; a new educational initiative to raise awareness of chronic care management; quarterly updates to the ESRD PRICER; and more!
Breaches are expensive and the price tag increases when preparation and formal documentation are lacking. One of the challenges of tracking security incidents and determining if a breach of PHI or PII is a reportable breach is developing a consistent assessment process and building a centralized breach tracking system.
