News

A September audit by the Office of Inspector General (OIG) said Alta Bates Summit Medical Center in Oakland, California, incorrectly billed Medicare for inpatient and outpatient services between 2017 and 2019, resulting in overpayments of $1.5 million.

Q: How will CMS make payments for radiation therapy (RT) services under the Radiation Oncology Model rule?

Q: During an outpatient visit, a nurse reviews the patient’s medical history and a physician performs an examination in the presence of the nurse. If you adhere to the 2021 E/M guidelines and use time as the controlling factor for code selection, can you report one E/M code for these shared services?

Q: Under what circumstances can a CE disclose PHI to family and friends of the patient? Does the patient always need to verbally consent to the disclosure? For example, if a patient brings a friend or family member with him or her into the emergency room, should the doctor assume that the patient is OK with the friend or family member being privy to PHI?

Organizations that received Provider Relief Fund payments of more than $10,000 will be required to report information on how PRF payments were used as well as  expenses related to the novel coronavirus that were not reimbursed (COVID-19), according to new HHS guidance.

Q: When providing end-of-life care, what are some of the key strategies for case managers to consider?

CHSPSC, LLC, a business associate providing services such as IT and HIM to hospitals and physician clinics owned by Community Health Systems in Franklin, Tennessee, agreed to pay $2.3 million to the Office for Civil Rights (OCR) and to adopt a corrective action plan to settle potential HIPAA violations.

During a meeting in early September, members of the ICD-10 Coordination and Maintenance Committee proposed creating new ICD-10-CM codes related to screening, exposure, and personal history for the novel coronavirus (COVID-19). The new codes, if finalized, would take effect in January 2021.

Q: What changes to inpatient dialysis MS-DRGs did CMS finalize in the 2021 Inpatient Prospective Payment System final rule?

Q: When would it be appropriate to report modifier -58 for a procedure performed during the postoperative period?