Advanced Search

Inpatient Facility Coding & Compliance Alert

Reimbursement:
Check Out the Top 3 CMS OPPS Changes That Could Affect Your Facility
Newly packaged services will change your bottom line. CMS issued the final Calendar Y... Read more
Quality Reporting:
Start Collecting Data Now for Upcoming OQR Measures
Heads up: Several new measures also apply to ASCs. As part of its OPPS and ASC Final ... Read more
Compliance:
Keep 3 Things in Mind to Streamline Your HIPAA Security Protection Plan
The New Year is the perfect time to get information security in place. If your facilit... Read more
Reader Question:
ICD-9 Procedure Codes Aren't Required for ED Facility Claims
Question: Should we be capturing ICD-9 procedure codes for ED facility coding?  I u... Read more
Reader Question:
Verify Facility Details Before Appending Modifier 27
Question: Should modifier 27 be appended on the visit to a second hospital when a patien... Read more
Reader Question:
Don't Add Technical Flow Cytometry Codes to 86828-86829
Question: I’ve been told that when reporting new codes for HLA Class I and/or Clas... Read more
Reader Question:
Get Clear Documentation of Who Makes Amendments
Question: If and when the patient’s electronic health medical records needs to be ... Read more
You Be the Coder:
H Codes for Non-Medicaid Cases
Question: One of our commercial insurers recently denied our claims with HCPCS codes H00... Read more
Admissions Coding:
Be Sure You're Up to Speed on the New 'Over Two Midnights' Rule
Warning: CMS has a different perspective on ‘inpatient’ or ‘observatio... Read more
News and Notes:
Don't Miss 3 Important CMS Updates for Hospitals
Hint: The clock is ticking for being part of the EHR Incentive Program. CMS is still a... Read more
ICD-10-PCS:
Here's Your Guide to Endovascular Embolization Coding Under PCS
Tip: Don’t overlook additional guidelines. Endovascular embolization involves in... Read more
Reader Question:
E/M Could Be Best When Second Physician Removes Nasal Packing
Question: One of our ED physicians removed nasal packs that another doctor at our hospit... Read more
Reader Question:
The Lowdown on What 'Teaching' Is in a Critical Care Scenario
Question: Some of my physicians are stuck on the “teaching” exclusion of the... Read more
Reader Question:
'Practitioner' Vs. 'Provider' Explained
Question: Many of my coworkers seem to use the terms “health care provider” ... Read more
Reader Question:
Take Advantage of Sequencing Leeway with Status Codes
Question: I’m coding the start of care (SOC) on a patient who was admitted to our ... Read more
You Be the Coder:
Here's When to Include Modifier QW With 89321
Question: Our Medicare contractor is denying payment for 89321, whether we’re... Read more
ICD-10-PCS:
Expand Your Documentation to Report Transfusion of Packed Cells (RBC) Next October
You need to get “autologous” and “non-autologous” straight in yo... Read more
News Flash:
3 Things You Need to Know During the Government Shutdown
Hint: Some agencies aren’t changing much. Whether you were worried that the gove... Read more
Therapy Services:
Rely on This Code for Hyperbaric Oxygen Therapy Services
Also: Be sure to report care by session for accurate payment. As more facilities add h... Read more
Reader Question:
Answer 6 Questions in Order to Follow the PHI Flow
Question: I’m always concerned about protecting our patients’ health in... Read more
Reader Question:
Device Key Simplifies Choosing Character 6 Under PCS
Question: My physician inserted a “sirolimus-eluting coronary stent.” How sh... Read more
Reader Question:
Balancing Between Identifiers and Privacy
Question: What guidelines should our behavioral health department follow to protect... Read more
Reader Question:
Document -- But Don't Bill -- Re-Evals in Acute Care
Question: I work in an acute-care setting, and I’m wondering how and when my ... Read more
Reader Question:
Not So FAST On Assigning Ultrasound Codes for Blunt Trauma
Question: What would be the CPT® code for ultrasounds done in ER for blunt ches... Read more
Reader Question:
Know the Difference Between EGD and PEG
Question: Should I code the following note as 43246? “The stomach was infla... Read more
You Be the Coder:
How to Handle Donor Transplant Suitability Testing
Question: Could you please explain how we should bill for typing by serology for a ... Read more
Reimbursement:
Proposed Medicare Fee Schedule Could Mean 3 Percent More for EDs in 2014
The CMS Proposed Rule Gives a Preview of What to Expect in 2014. Good news for your ho... Read more
Infusion Procedures:
Follow 4 Steps for More Accurate Intra-Arterial Chemotherapy Coding
Tip: Start by understanding what ‘push’ means. When reporting treatment o... Read more
Compliance:
In Your Facility on Par With New Health Record Access Rules?
Indecent disclosure: Why access report requirements are nothing to sneeze at. New HIPA... Read more
Reader Question:
Focus on Initial Reason for Admission When Listing Diagnoses
Question: A patient was admitted for a total hip replacement because of arthritis of the... Read more
Reader Question:
Base Intraoperative Touch Prep Coding on Site Being Treated
Question:  Please clarify if there’s a difference in how we should bill the f... Read more
Reader Question:
Report Pregnancy Diagnosis First, Even With Admission for Other Reasons
Question: When coding a psychiatric inpatient admission on a pregnant woman, do you use ... Read more
Reader Question:
Verify MDs Before Coding Post-Op Seroma Closure
Question: Our emergency physician sutured a bleeding post-operative seroma at the incisi... Read more
You Be the Coder:
Reporting E Codes With PSI 15
Question: Our facility has created a team to focus on documentation concerns related to ... Read more
Coding Strategies:
Master These Strategies and Ace Billing for Subsequent Admissions
Discharge and readmission can be reported twice. If you’re not clear on the chan... Read more
Privacy:
Know Your Risks Versus Benefits With PHI Portal Processes
Don’t underestimate the importance of a good log out procedure. Your patients ha... Read more
HIPAA Compliance:
7 Steps Keep Your PHI "Cloud" Storage From Fogging Up
Exercise caution in choosing your vendor -- or risk leaks. If you’re like m... Read more
ICD-10-PCS:
Quick Reference Tool Helps You Correctly Identify Approach
Identify the procedure site  to ace PCS coding. Every ICD-10-PCS code has seven c... Read more
Reader Question:
Bypass The Confusion Of Coding Pericardiectomy
Question: An inpatient underwent a complete pericardiectomy without cardiopulmonary bypa... Read more
Reader Question:
Ace Coding For HIV Tests
Question: A two-year old infant was admitted with pneumonia due to respiratory syncytial... Read more
Reader Question:
Ensure Deletion Of PHI Before Sending An E-mail
Question: I sometimes e-mail patient records to consultants for help on how to bill. How... Read more
Reader Question:
Review Nerve Blocks With Fibroid Procedures
Question: What codes should I report when the radiologist performs a hypogastric nerve b... Read more
You Be the Coder:
Hip Replacement With Anemia Complication
Question: An inpatient underwent hip replacement. The diagnosis on the discharge summary... Read more
E/M Coding Strategies:
Advice Helps You Overcome the Physician Coding Challenge for Observation Services
Here’s why every minute counts when you report these codes. When reporting obse... Read more
Hipaa Compliance:
Know Your Ehr Risks And Avoid Big Fines
Perform a risk analysis and rule out your vulnerabilities. The compliance status of yo... Read more
Inpatient Therapy:
Grasp Therapy-Specific Changes in the Works for 2014 Snf Pps
CMS wants clarity in therapy days vs. therapy visits. Heads up: The Centers for Medica... Read more
Reader Question:
Severity of Injury Determines E/M Coding in the Emergency Department
Question: A patient presented to the ED with an uncomplicated laceration to the hand. Th... Read more
Reader Question:
Determine Who Can Perform Record Amendments
Question: If and when the patient’s electronic health medical records needs to be ... Read more
Reader Question:
Watch the Calendar for When to Report 644.21
Question: The obstetrician recommended that we report early onset of labor for a patient... Read more
Reader Question:
Check 43.99 for Ivor-Lewis Esophagogastrectomy
Question: What is the correct procedure code for Ivor-Lewis esophagogastrectomy? Te... Read more
Reader Question:
Don't Disclose PHI Without Patient Authorization
Question: Who’s authorized to make a request to review a patient’s medical r... Read more
You Be the Coder:
Identify Chief Complaint
Question: A patient was admitted to observation care with a chief complaint of cramp of ... Read more
Critical Care:
Do Your ED Docs Capture All Their Critical Care Time?
Check out these resources to see if your policies are in order. All reimbursement hing... Read more
Chemotherapy:
Get Your Best Infusion Pay by Following 96401-96549 Guideline Revisions
Take note: One coding example specifically applies to facilities. If your facility pro... Read more
HIPAA:
Are Your BA Agreements Risk Magnets? Find Out Here
Heads up: Regulations apply to any vendor or subcontractor. Federal scrutiny — ... Read more
ICD-10-PCS:
Select the Appropriate Cesarean Procedure and Diagnosis Codes With This Advice
For a cesarean, ICD-10-CM guidelines say to use this code as your primary dx. Although... Read more
Reader Question:
Include Specific Critical Care Times on EMR Templates
Question:  Would a template listing a range of time spent rather than a specific ti... Read more
Reader Question:
Save 03.91 for Non-Surgery Administrations
Question: An anesthesiologist used both general anesthesia and an intrathecal during a p... Read more
Reader Question:
Back Up Resident Services With MD Confirmation
Question: If no linking statement by the attending physician is present, which part of t... Read more
Reader Question:
Verify Situation Before Coding Coumadin Toxicity
Question: A patient was admitted to the hospital with hematuria which the physician susp... Read more
Reader Question:
Documentation, Not Initial Thinking, Guides Primary
Question: Sometimes our chart reviewer changes the COPD exacerbation and reports pneumon... Read more
You Be the Coder:
Choosing Codes With No Pathological Diagnosis
Question: The pathologist examined a portion of rib removed for thoracic outlet syndrome... Read more
IPPS:
Proposed Inpatient Payment Policy Could Bring Good News to Facilities
Here’s your chance to let CMS know what you think. Changes are afoot for facilit... Read more
Compliance:
Follow 5 Steps to Guard Against Device Dangers
Here are the HIPAA requirements your facility must know. The ever-growing presence of... Read more
ICD-10-PCS:
Pinpoint 4 Factors When Coding Radiation Oncology Procedures
Type of treatment and isotope help guide your selection. ICD-10-PCS implementation is ... Read more
Fraud Alert:
Miami-Based Clinic, Owners, and Operators Sentenced for $50 Million Fraud Scheme
Medicare Fraud Strike Force adds another clinic to its list. Biscayne Milieu (a Miami-... Read more
Reader Question:
Stay Away From Reporting 87502 and 87631 Together
Question: Our lab tests a bronchial lavage specimen for respiratory viruses by mult... Read more
Reader Question:
Get More Details Before Coding Acute Conditions in Home Care
Question: I’m shifting from our inpatient coding to reporting the hospital’s... Read more
Reader Question:
Find the Simple Solution to Complicated Wound Coding
Question: We have a few patients who are receiving care in our wound center for trauma w... Read more
Reader Question:
Codes 89.67 and 00.17 Work Together for Vasopressor Support
Question: I’m having some trouble coding for septic shock patients who are given p... Read more
You Be the Coder:
Look for This to Select Correct Sialolithiasis Service Code
Question: The patient is a 54-year-old female who presents with right-sided face pain. E... Read more
Quality:
Key In On 5 Ways to Improve Pressure Ulcer and CAUTI Quality Measures
See how inpatient rehab can help you look good to CMS. Managing pressure ulcers and c... Read more
Health Information:
HHS Changes Could Lead to More Incentive Pay, Better Readmission Rates
Watch for new goals regarding health info exchange. Hospital financial people, take no... Read more
HIPAA:
Follow These 7 Steps to Protect PHI 'In the Cloud'
Tip: Pay special attention to data protection, breach protocols.  If you’re... Read more
ICD-10:
Know These Phrases to Ease Your ICD-10 Transition
Good news: You’re already familiar with many go-to terms. While your hospital p... Read more
Reader Question:
List Treated Neoplasm as Principal Diagnosis
Question: Is there ever a time when a secondary malignancy can be the first listed code ... Read more
Reader Question:
Tie 96367 to Initial Infusion Code 96365
Question: A 66-year-old patient was admitted through the ER and received a two-hour ther... Read more
Reader Question:
Cover Bases When Handing Off a Patient at Shift Change
Question: When an emergency physician turns an incomplete patient encounter over to... Read more
Reader Question:
Consider All Factors When Coding Upper and Lower Extremity X-Rays
Question: In a single session, we performed standing AP, lateral, and tangential vi... Read more
You Be the Coder:
Watch for This Situation When Coding Excisional Debridement
Question: The physician documented excisional debridement in the inpatient progress note... Read more
Observation Care Strategies:
Ensure Your Timekeeping is Accurate for Observation Care Services
Get the scoop on the latest CMS stance on counting minutes. Counting the time a patie... Read more
Reimbursement:
Avoid 4 Mistakes When Coding Discharges -- and Save Your Facility Thousands
Tip: Pay special attention to next-day discharge trap. Even the most experienced coder... Read more
ICD-10-PCS:
Prepare Physicians Now for More Detailed Transfusion Notes Under ICD-10-PCS
Heads up: Sketchy details will lead to almost 50 possible code choices. Physician note... Read more
Compliance:
CMS Helps Ensure Your Mobile Devices Meet HIPAA Standards
Tip: Delete info as soon as it’s no longer needed. Many physicians and facilitie... Read more
Reader Question:
Check 99221-99233 for Inpatient Consultation
Question: The cardiologist on call in the hospital was called in for a cardiology consul... Read more
Reader Question:
Report Reason for Admission Before Underlying Condition
Question: The admitting physician documented alcoholic gastritis due to chronic alcoholi... Read more
Reader Question:
CPAP for COPD Outweighs Pneumonia as Principal Diagnosis
Question: A patient was admitted with a chief complaint of shortness of breath. He also ... Read more
Reader Question:
Start With DRG 313, Then Move to More Specific Choice
Question: A patient was admitted for observation of suspected cardiovascular disease. Wh... Read more
Reader Question:
Use Caution When Billing Extra for Special Rooms
Question: Can the hospital charge a higher room rate for patients in certain situations,... Read more
You Be the Coder:
Pay Attention to This With Lumpectomy Margins
Question: The pathologist examines a specimen that the surgeon labels “breast lump... Read more
Observation Care:
Ensure Admission Is Justified Before Assuming G0379 Applies
Tip: Get 3 things in writing, or billing observation care won’t fly. Observation... Read more
ICD-10-PCS:
Let Obstetrics Section 1 Give You an Easy-to-Understand Look at PCS
Key in to root operations for help with other sections. If you’re looking for a ... Read more
Compliance:
Make Moves Now to Steer Clear of Potential Privacy Breaches — and Big Bucks to Correct Them
Follow these 8 tips to comply with the HIPAA security rule. Even a small HIPAA breach ... Read more
Reader Question:
Quality Measures Get Added to Contract Equations
Question: I’ve heard that quality issues will become a bigger part of contrac... Read more
Reader Question:
EMR Templates Need Specific Critical Care Times
Question: Would a template listing a range of time spent rather than a specific tim... Read more
Reader Question:
Watch for ICD-10 Codes to Be Added to NCDs
Question: We have special arrangements to code office services for one of our physi... Read more
Reader Question:
Let the Physician State Reason for Not Obtaining History
Question: How does CMS audit records when the acuity caveat is used to explain a ph... Read more
Reader Question:
Don't Worry Too Much Yet About Medicare Payment Board
Question: I heard something about a new physician group being formed by President O... Read more
You Be the Coder:
Heads Up for Your ICD-10 'Atypical Chest Pain' Code
Question: Chest pain is a common diagnosis in our Emergency Department. What’... Read more
Coding Strategies:
Know the Purpose of Care Before Billing Observation Services
Tip: Watch for the 5 most common care paths. Observation services are a vital part of ... Read more
ICD-10:
Prepare Now for How ICD-10 Will Change ED Coding
Whether you’re coding dyspnea or encounters with turtles, specificity rules the pr... Read more
Compliance:
Follow These 5 Steps to Organize a Top-Notch Revenue
With hospitals fighting harder for every dollar they receive, your facility may be looki... Read more
Patient Safety:
Follow These Strategies from WHO to Bolster Your Patient
Remind employees it’s everyone’s job to keep track of identities. It&rsqu... Read more
Reader Question:
Tie Canceled Surgery Back to Primary Diagnosis
Question: A patient was admitted for a total hip replacement (THR) because of severe art... Read more
Reader Question:
Current Results Can Trump Previous HIV Positive Test
Question: A two-year-old child was admitted with pneumonia due to respiratory syncytial ... Read more
Reader Question:
Push for Specific Time Statements, Not Template Times for Critical Care Services
Question: We sometimes have trouble getting the physicians to accurately document the le... Read more
Reader Question:
Watch for Potential PHI Slips Before Clicking 'Send'
Question: I sometimes e-mail patient records to consultants for help on how to bill. How... Read more
You Be the Coder:
Understand Consequences of Leading Queries
Question: Sometimes we coders need to ask a physician to clarify things in a patient&rsq... Read more
Available Years:  2013  2012