Physicians and other providers practice in many different areas within a hospital. To accurately code physician and provider services, coders must know and understand the place of service (POS) codes.
Ensuring detailed documentation isn't important only with respect to documenting medical necessity. Case managers should also ensure physicians are including enough information in patient records to help them accurately estimate length of stay (LOS), says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, an independent health information management consultant in Madison, Wis.
Law enforcement officials in Texas, Florida, and New York recently announced plea agreements and fines involving the billing of an unapproved prescription drug and Medicare fraud.
One of the major changes to the 2013 CPT Manual is the replacement of the term "physician" with "physician or other qualified healthcare professional" (QHP) in a wide range of codes.
Successful programs to reduce preventable hospital readmissions range from the transitional care model created by Mary Naylor, PhD, FAAN, RN, a nurse researcher at the University of Pennsylvania, to Project RED, created by the Commonwealth of Massachusetts. Kathleen Heery, MS, RN, CCM, and Cheryl Pacella, DNP(c), HHCNS-BC, CPHQ, the homecare consultant and quality advisor at CAP Consulting, LLC, discussed the secrets to their success during "Reducing Readmissions by Improving Transitions in Care," an HCPro webcast.
