CMS is expected next week to discuss potential changes to 2-midnight rule audits by Quality Improvement Organizations after quietly suspending the reviews in early May.
Charging for bedside procedures is a relatively new concept. Reporting all of these services under the room rate means losing data vital to evaluating the cost of an individual patient’s care and appropriate reimbursement. Read this excerpt from Billing for Ancillary Bedside Procedures by Denise Williams, RN, COC to learn more.
Q: Our providers are reluctant to document a correlation between symptoms and a detailed diagnosis. Do you have any good ways to get them to do this? For example, our providers document "diabetes" but they often don't include additional details that should be there (e.g., gestational diabetes or type II diabetes mellitus in pregnancy).
This week’s updates include July calendar year 2016 quarterly update to the Medicare Physician Fee Schedule Database; Claim Status Category and Claim Status Codes update; and more!
A county public health director in New York state recently presented a plan for an opioid task force that would employ a case manager dedicated solely to locating inpatient rehabilitation beds and follow-up counseling for addicts.
CMS recently released two July 2016 quarterly updates: Transmittal R3523, the July update to OPPS, and Transmittal R3524CP, the related July update to the integrated outpatient code editor (I/OCE). Hospitals are strongly encouraged to review both of these updates to obtain important guidance on the billing, processing, and payment of inpatient and outpatient hospital services covered under Medicare Part B.
This week’s updates include a survey and certification letter for the adoption of 2012 Life Safety and Health Care Facilities Code; the July 2016 updates to the Integrated Outpatient Code Editor and hospital OPPS; and more!
Sepsis isn’t the only clinical condition with an updated definition that could impact coding and documentation. A task force of the National Pressure Ulcer Advisory Panel (NPUAP) recently changed terminology related to pressure ulcers that includes new terms that are not yet part of ICD-10-CM.
