News & Analysis

July 1, 2012
Case Management Monthly

If you merely review patient charts and compare them to screening criteria, such as InterQual® and Milliman®, you're not doing enough.

July 1, 2012
Briefings on APCs

Pain is an expected component of injuries, illnesses, and surgical procedures. Let's face it, breaking your leg hurts. In some instances, however, the patient's pain is unexpected or is worse than predicted. Sometimes, the pain can last well beyond the time it should have resolved.

July 1, 2012
Briefings on APCs

Our coding experts answer your questions about correct use of modifier –PD, coding infusions to correct low potassium levels, payment for HCPCS code J2354, appropriate reporting of IV push followed by infusion of the same drug, and the difference between modifiers –AS and -80.

July 1, 2012
Briefings on APCs

To correctly assign codes for any surgical procedure, coders need to have an operative (OP) report. But simply having the OP report isn't enough. Coders also must be able to read the report and pick out the important information.

July 1, 2012
Briefings on APCs

A physician can debride a wound to remove dead, damaged, or infected tissue so the remaining healthy tissue can better heal. Coders need to look for specific information in the documentation of wound debridement.

June 1, 2012
Case Management Monthly

For many patients, home health services can mean the difference between a successful recovery and a hospital readmission, but patients who need services go without because of confusion over eligibility requirements.

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