UnitedHealthcare’s (UHC) plan to require in-network, freestanding and outpatient laboratory claims to contain a unique code for most lab testing services is poorly timed and poses significant implementation hurdles, the American Hospital Association (AHA) said.
Q: A recent study by the California Lab Policy reported 50% of unsheltered individuals experience "tri-morbidity" (co-occurring physical health, mental health, and substance abuse challenges), compared to just 2% of sheltered individuals. What can case managers do to assist these patients?
The use of chronic care management (CCM) CPT codes increased over a four-year period, but physicians infrequently reported codes for complex CCM, according to findings from a review of Medicare claims recently published in the Annals of Family Medicine.
Q: When is it appropriate to report both flash or acute pulmonary edema and acute on chronic heart failure (diastolic, systolic, or other) in ICD-10-CM? What other etiologies lead to flash pulmonary edema and how do I know when to query?
CMS provided clarification on submitting inpatient claims for patients diagnosed with novel coronavirus (COVID-19) without a positive viral test, in an update to MLN Matters SE20015 released September 11.
