This week’s Medicare updates include clarification on portable x-ray necessity, recommendations from the hospital outpatient payment advisory panel, an adjustment to the amount in controversy threshold amounts for 2018, and more!
Outsourcing some HIM functions is common at many organizations. The decision might initially be spurred by staffing shortages or budgetary concerns, but many outsourcing arrangements become long-term projects.
Mrs. X, a 30-year-old pregnant mother of two with a supportive husband, is admitted to a Midwest rural hospital. She delivers the baby soon after, and the birth is uneventful.
Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
