Q: A patient receives treatment for two ulcers, one on his foot and one on his hip. The physician performs a subcutaneous debridement to treat the foot ulcer and a muscle debridement to treat the hip ulcer. How would this be reported?
Q: Our facility is interested in conducting audits for observation and drug administration services, but understand they should be considered differently from other services. What details should we take into account before we begin?
Rita Luthra, MD, a gynecologist from Longmeadow, Massachusetts, was convicted on April 30 by a federal jury of one count of violation of HIPAA and one count of obstruction of a criminal health care investigation.
CMS is looking to reduce reporting and documentation requirements for inpatient rehabilitation facilities (IRF) in the 2019 IRF payment system proposed rule, published in the Federal Register May 8. The proposed changes could come as a relief to IRFs that have seen a significant uptick in audits and denials.
A diagnosis in the emergency department is not always guaranteed, but reframing patient encounters can ensure patient needs are met, according to a study in Annals of Emergency Medicine.
Q: If a patient is seen for a pressure ulcer on the foot related to diabetes, would you report a diabetes diagnosis code? If surgical debridement is performed and the patient receives treatment for their diabetes, can you charge for both an office visit and debridement?
CMS recently clarified the use of modifier -KX (requirements specified in the medical policy have been met) in response to an Office of Inspector General report that identified conflicting guidance that resulted in $4.6 million in improper payments.
