Healthcare providers are using ICD-10-CM Z codes at an increasing rate to document social determinants of health (SDoH), according to a new report from CMS.
Q: How do we bill for services when our utilization review (UR) team determines postdischarge that an inpatient admission was not medically necessary? Are these services billed as outpatient or inpatient?
Several Medicare claims for trastuzumab mutli-dose vials billed over the last three years failed to comply with Medicare requirements in part due to the improper application of modifier -JW, according to a study reported in the January 2020 Medicare Quarterly Provider Compliance Newsletter.
Q: We are finding that physician documentation is lacking for vaping-related lung injuries at our hospital, making it hard to report the condition accurately. What can our coding team do to remedy this situation, and how do we accurately report vaping-related lung injuries in ICD-10-CM?
Q: In OCR's $3 million settlement with Touchstone Medical Imaging, one of Touchtone's FTP servers allowed uncontrolled access to patients’ PHI. This permitted search engines to index the PHI of patients, which remained visible even after the server was taken offline. What missteps can providers avoid in this arena?
The 340B drug discount program does not appear to incentivize hospitals to use more expensive drugs, according a Medicare Payment Advisory Commission (MedPAC) report presented at its January 17 meeting.
Q: My organization is interested in starting a program to address food insecurity among patients in our community. What factors should we consider when forming the program?
A Texas-based healthcare company reached a voluntary resolution agreement with HHS and the Office for Civil Rights (OCR) on January 16 regarding allegations that it had failed to provide effective communication to hearing-impaired patients.
The American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) recently filed a lawsuit against the Department of Health and Human Services (HHS) for continuing to reduce payments for hospital outpatient services provided in grandfathered, off-campus provider-based departments (PBD) in the fiscal year 2020 OPPS final rule.
