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Q: When a diabetic patient has arteriosclerotic peripheral artery disease (PAD), should an additional ICD-10-CM code be assigned from subcategory I70.2- (atherosclerosis of native arteries of extremities) to describe the affected vessel and laterality?

Q: What strategies can a case manager use to reach patients who are unwilling to accept resources?

The University of Rochester Medical Center (URMC) recently paid a $3 million civil monetary penalty to the Office for Civil Rights for HIPAA violations that include failing to encrypt mobile devices. URMC is one of the largest health systems in New York with more than 26,000 employees.

The Patient-Driven Payment Model (PDPM) has so many nuances that can impact reimbursement that it is near impossible for SNFs to consider and capitalize on them all. Check your processes and procedures to ensure you’re taking advantage of or protecting against the following aspects of PDPM.   

Q: Do we need to use the same revenue code for the same service across all payers, even non-Medicare payers?

An August report from the Office of Inspector General (OIG) found that Oceanside Medical Group, a clinic providing mental health services in Santa Monica, California, received $2.6 million in overpayments for psychotherapy services by failing to comply with Medicare billing and documentation requirements.

Q: Does a psychiatrist need to document a physical examination and a review of prescriptions in order to support the reporting of CPT code 90792 (psychiatric diagnostic evaluation with medical services)?

Q: HHS has a proposed rule out that would make sharing of health information to patients easier through the use of APIs and smartphones. What’s important to know for making these apps secure as we work with vendors who will ultimately be producing these apps for a covered entity?

Along with its annual updates to the inpatient-only list, the 2020 Outpatient Prospective Payment System (OPPS) final rule finalized a proposal that will give hospitals a grace period to adjust internal policies for procedures recently removed from the inpatient-only list.

Q: How are "autonomy" and "competence" defined in case management when describing patients?