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.
CMS recently released updated guidance on billing intensity-modulated radiation therapy (IMRT) after an OIG audit found a 100% error rate in billing certain IMRT planning services.
As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption.
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.
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.