In 2018, most organizations held the line on coder productivity, according to the results of sister publication HIM Briefings’ 2018 coding productivity survey.
A retrospective study recently published in Pediatrics found that a statewide administrative database containing billing and coding information for newborn discharges accurately captured risk factors and outcomes for perinatal patients. This suggests that administrative databases may be effectively used to analyze performance metrics and accelerate data quality improvement efforts locally.
Pay close attention to new CPT documentation and coding guidance for reporting radiological imaging. For example, a new paragraph titled “Imaging Guidance” in both the surgery and medicine guidelines advises that even when imaging guidance or supervision are included in a surgical procedure code, you must still follow the radiology documentation requirements in the CPT manual.
An inpatient study recently published in the Journal of the Academy of Nutrition and Dietetics demonstrates the importance of accurate ICD-10-CM reporting for malnutrition to ensure accurate Medicare severity diagnosis-related group (MS-DRG) assignment and the establishment of appropriate comparison benchmarks such as expected geometric mean length of stay (GMLOS).
Modifier -JW is used to describe drug amounts that are discarded and not administered to any patient. This does not reduce the payment for the drugs, so this is an informational modifier, but it is a mandatory modifier.
The Office of Inspector General (OIG) will be taking a closer look at payments for inpatient claims subject to CMS’ post-acute transfer policy, according to a recent update to the OIG work plan.
Increased access to urgent care centers (UCC) may decrease the number of patients who seek treatment for low-acuity conditions in hospital emergency departments (ED), according to findings from a retrospective study recently published in the American Journal of Emergency Medicine.
