Pat, a nurse case manager, had noticed an increase in the number of uninsured patients at the hospital where she worked. She didn’t know why the past few months had seen so many uninsured come through the doors, but she wondered whether it had to do with her state’s healthcare reform.
If the attending physician writes an admission order and later decides that the case should have been outpatient and then writes and order for outpatient, do we still need utilization review involvement and condition code 44 to change to observation?
I always get invigorated after attending a good educational tradeshow. This past October’s AHIMA national conference provided a wonderful showcase of lectures, workshops, vendors, and events that seemed to have something for everyone.
Q: We have an off-campus provider based department that is “non-excepted,” so we have to report modifier –PN (nonexcepted service provided at an off-campus outpatient, provider-based department of a hospital). Is that for just the services that would be paid under the OPPS if the department were “excepted”?
More than 359,000 providers will participate in CMS’ four alterative payment models, which are aimed at compensating providers for quality of care and thereby delivering better care.
