Billing and reimbursement

There has been some confusion surrounding a possible Recovery Auditor-related provision in the American Taxpayer Relief Act of 2012, also known as the fiscal cliff deal.

This week’s note is about hot topics from Medicare/Medicaid payment Institute. Click the link above for more information and an in-depth analysis. 

CMS' 2014 IPPS final rule redefined inpatient admissions when it implemented the 2-midnight rule, which requires a validated physician order, documentation of medical necessity, and the expectation of a stay crossing two or more midnights.

This week’s note is about changes to CMS policies related to preadmission inpatient-only procedures. Click the link above for more information and an in-depth analysis. 

This week’s note is about claims with outpatient psychiatric services. Click the link above for more information and an in-depth analysis.

This week’s note is about billing related to Investigational Device Exemption studies. Click the link above for more information and an in-depth analysis. 

Ensuring detailed documentation isn't important only with respect to documenting medical necessity. Case managers should also ensure physicians are including enough information in patient records to help them accurately estimate length of stay (LOS), says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, an independent health information management consultant in Madison, Wis.