News & Analysis

August 1, 2012
Case Management Monthly

If your utilization review (UR) committee is like many others nationwide, it may not have actually met in years-and chances are your UR committee members are secretly glad that's the case. Let's face it; those meetings can be a complete snooze.

August 1, 2012
Case Management Monthly

Which questions should a case manager ask to ­improve documentation and better reflect the severity of a patient's condition?

August 1, 2012
Briefings on APCs

In this month's issue, our coding experts answer questions about how to differentiate between modifiers -52, -73, -74, coding for negative pressure wound therapy, and billing the technical component of pathology services.

August 1, 2012
Briefings on APCs

A surgeon performs a diagnostic shoulder arthroscopy before repairing a patient’s rotator cuff. The surgeon knew ahead of time that he or she would be repairing the rotator cuff. Should a coder or biller append modifier -59 (distinct procedural service) to the CPT® code for the diagnostic shoulder arthroscopy to ensure reimbursement for both procedures?

August 1, 2012
Briefings on APCs

Coders can run into two types of edits that may ­require them to append modifier -59 (distinct procedural service) to override: NCCI edits and medically unlikely edits (MUE).

August 1, 2012
Briefings on APCs

Coding for physician services doesn’t always match coding for facility services, which can cause problems for coders who code records for both. ED E/M is one area where different rules come into play.

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