Q: How should we handle canceled inpatient-only procedures? Are these are still coded to the full intended procedure under OPPS and modified with a -73 or -74 modifier? Most of these cases result in changed orders to outpatient due to the patient being discharged the same day. Can the original inpatient order be used?
Q: We have a diabetic patient with chronic kidney disease and hypertension who was admitted for treatment of chronic kidney disease (an Insertion of an arteriovenous graft for dialysis). Which ICD-10-CM code should be sequenced as the principal diagnosis – the diabetic complication code or the hypertensive renal disease code?
The October 2019 OPPS quarterly update reassigned certain injections from non-payable to separately payable. CMS also revised the status indicators for several recently approved advanced diagnostic laboratory tests (ADLT).
The Revenue Integrity Symposium is a conference that truly speaks to the contemporary and emerging issues that revenue integrity professionals grapple with.
The Office of Inspector General (OIG) will review Medicare’s diagnosis-related group (DRG) window policy to determine whether the program could save money by expanding the policy to include more days, according to an update to the OIG Work Plan.
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.
