News & Analysis

May 1, 2013
Briefings on APCs

Our experts answer questions about modifiers for diagnostic interventional procedures, Medicare recognition of CPT® code 9066, reporting add-on code for psychotherapy with interactive complexity, reporting G0378 for all payers, and wound care coding.

May 1, 2013
Briefings on APCs

CMS corrected edit 84, added five APCs to the I/OCE, deleted two APCs, and changed the description of another as part of the April updates to the I/OCE. In addition, CMS deleted all of the genetic testing modifiers, retroactive to January 1.

May 1, 2013
Briefings on APCs

The AMA revised the molecular pathology codes in the CPT® Manual in 2012, but at that time CMS did not adopt the codes as it was still debating whether and how to change the reimbursement system for these services going forward. For CY 2013, CMS elected to recognize the codes, which meant it had to finalize how to pay for them. While CMS did not change pamyent for these services under the Clinical Laboratory Fee Schedule (CLFS) despite industry pressure, its change to the new codes means a change in the payments providers can expect this year and in the future.

May 1, 2013
Strategies for Healthcare Compliance

Q. Can paper patient records be kept in a public storage unit? The storage company we are considering has a digital entry at the main gate. We would also have a keyed lock on the storage unit door.

May 1, 2013
Strategies for Healthcare Compliance

This year's Recovery Auditor Benchmarking ­Report surveyed 325 respondents, representing both small and large hospitals, from all four Recovery ­Auditor regions. It may not come as a huge surprise to many that the main theme of this year's survey is the expanding state of the Recovery Auditors (RA), and the fact that they continue to gain speed and extend their reach.

April 1, 2013
Case Management Monthly

It is an ongoing challenge for case managers to ­determine whether a patient is more ­appropriately placed as an inpatient or in observation. Below are some real-life examples provided by Deborah Hale, CCS, CCDS, in the HCPro book ­Observation Services: A Guide to ­Compliant Level of Care Determinations.

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