CMS could have saved its beneficiaries an additional $2.9 million in 2017 had it implemented a more expansive price substitution policy for Part B drugs, according to an Office of Inspector General (OIG) report.
Q: What would be reported as the principal diagnosis if a patient was admitted with both a urinary tract infection (UTI) and sepsis? What would be reported first if the patient developed a catheter-associated UTI with sepsis?
Findings from a Comprehensive Error Rate Testing (CERT) study show that insufficient documentation caused most improper payments for chiropractic services billed to Medicare in 2018, according to the July 2019 Medicare Quarterly Compliance Newsletter.
The New York City Fire Department (FDNY), which operates ambulances, disclosed in August that 10,253 patients treated or transported by the FDNY from 2011 to 2018 may have had their protected health information (PHI) compromised after an external hard drive containing unencrypted data went missing in March, according to an FDNY press release.
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.
