Matty, an expert utilization review (UR) case manager, is shocked when she receives a letter denying payment for the entire hospital stay of Michael, who has recovered after falling severely ill with the novel coronavirus (COVID-19).
This week's instructor note dives into the recent instruction from CMS on requirements for reporting a COVID-19 diagnosis on a claim in order for the claim to be eligible for a payment increase.
Q: If a person has a history of substance abuse, but at the time of admission appears to be of sound mind, is that patient’s personal representative still entitled to receive information about the patient’s treatment and status?
CMS extended the education and operations testing period for the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging through 2021. The education and operations testing period, which started January 1, 2020, was slated to close at the end of the year.
Finding the right applicant to fill a vacancy in the coding department can be challenging. Organizations can help close the gap and improve their coding staff by implementing an apprentice program. Use this sample education schedule to help develop a program at your organization.
This week’s Medicare updates include new guidance on elective procedures for end-stage renal disease patients during the public health emergency, new additions to the OIG work plan, updated data on opioid use in Medicare Part D, and more!
