Managers should not assume that they can review every guideline, every item in Coding Clinic, or every coding-related issue targeted by the OIG or Recovery Auditors. However, those issues that have been identified as the result of denials, external coding audits, or quality initiatives should surface to the top of the audit list for the coding manager.
Device-dependent edits require reporting a device code with procedures CMS has designated to be device intensive, and they are meant to ensure that device costs are accounted for in Medicare rates for device-intensive procedures.
Q: A payer has begun denying authorization for admissions and diverting patients from our hospital to one of our competitors, even when our hospital is closer. Is this a common practice among payers? What language should we add to the contract to discourage it?
Employees need to know what to do and what not to do when it comes to ensuring protected health information (PHI) remains secure. That’s where TeachPrivacy comes in as an excellent resource for quality staff training.
Q: The 2020 ICD-10-CM update added several new codes for legal interventions. What are these codes, and can they be assigned based on nonphysician documentation?
More than 70% of heath data breaches in the past decade involved sensitive demographic or financial information, leaving 159 million people vulnerable to identity theft and fraud, according to a new study.
