Developing an outpatient CDI program isn't just about metrics--departments needs to consider how to engage providers and interact with other teams to be truly effective.
Most covered entities still use mailings to communicate with patients and members, so it is worth revisiting Aetna's 2017 mailing breach and the surrounding litigation to understand where negligence occurred and to take away some valuable lessons learned.
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.
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?
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.
