Q: A patient presents to a wound care clinic for assessment of a 15 sq. cm open wound. A nurse evaluates the wound for size, depth, and evidence of inflammation and performs sharp selective debridement. Would it be appropriate to bill an E/M code and if so, should we report modifier -25?
Q: Is there anything that a hospital needs to do regarding HIPAA and the confidentiality of famous patients? Obviously employees shouldn’t snoop, but can you recommend any added protections?
Oversight of the practice of case management is a complex process. A number of moving parts must be factored in, including education, credentialing, and professional qualifications.
The American Hospital Association and several other hospital groups released a joint statement criticizing CMS’ proposed price transparency policy outlined in the calendar year 2020 OPPS proposed rule that would require hospitals to publish negotiated rates with private payers.
Q: A diabetic patient is diagnosed with a gangrenous decubitus ulcer of the left heel and admitted to the hospital for treatment. If the provider documents an association between diabetes and the decubitus ulcer, which condition should be sequenced as the principal diagnosis?
While there are many conferences that touch upon aspects of revenue integrity, RIS is the only one entirely dedicated to the topic. Plus, it is a great way to meet other professionals in the field of revenue integrity who are facing similar challenges and have similar interests.
CMS is proposing several revisions to its clinical diagnostic laboratory date of service (DOS) policy in the FY 2020 OPPS proposed rule, including requiring ordering physicians to determine whether tests are intended to guide treatment during a current or future outpatient encounter.
