It's been more than three years since CMS introduced a subset of modifiers it wants providers to report instead of modifier -59 (distinct procedural service), but they're still optional as barely any new guidance has been released.
UMass Memorial Medical Group Inc. and UMass Memorial Medical Center Inc. reached a $230,000 settlement with the state of Massachusetts in response to two data breaches that exposed the personal health information of more than 15,000 Massachusetts residents.
Many case management directors have questions that arise from time to time on a variety of topics. Here are two such questions along with responses that may help if you’re facing similar challenges.
A case manager works on a postacute transfer plan for a patient who is critically ill with sepsis and at risk for acute renal failure. Because the patient has a history of IV drug use, it is likely that long-term acute care hospitals will deny him admission.
Q: I received confusing guidance regarding CPT coding for a segmental spinal fusion with pedicle screws placed at L3 and L4 vertebrae. Would it be appropriate to report CPT code 22612 with add-on code 22614 for this procedure?
Q: How long are we required to retain the records of out-of-state patients? Do we follow HIPAA’s record retention requirements, our state record retention requirements, or the record retention requirements of the state in which the patient lives?
