Most case managers have had a spat with a physician at one time or another.
Maybe a physician discharged a patient who may not have been clinically ready for discharge, or perhaps a physician disagreed with a case manager about the proper level of care for a particular patient.
Earlier last decade, when patients came into the ED at Christiana Care Health System in Newark, DE, they were difficult to track. In 2004, Christiana served about 90,000 patients per year. It was a busy place. Patients were bustled from their rooms to testing locations and back again.
Fortunately for providers, CMS decided not to cap outpatient payment rates for cardiac resynchronization therapy defibrillator (CRT-D) procedures at the standardized inpatient rate. The agency announced its decision as part of the CY 2012 OPPS final rule released November 1, 2011.
Our coding experts answer your questions about determining ED visit level, coding open reduction and internal fixation of a radius fracture, and coding image-guided minimally invasive lumbar decompression.
