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Inpatient Facility Coding & Compliance Alert

Reimbursement:
Don't Miss This if Short Inpatient Stays Are Common in Your Facility
Get familiar with MedPAC policy recommendations and more. The high profitability of on... Read more
EHR:
Take Advantage of Extended Deadline for 2014 Hospital Meaningful Use Reporting
Act in time to reap incentives in 2016. Good News! CMS has extended the deadline for e... Read more
Coding Update:
Here's Your Update on Inpatient Codes Changes in the OPPS Final Rule for 2015
Take a sneak peek at the three codes that concern you.   In 2015, you can wi... Read more
ICD-10 Update:
Get the Scoop on Multiple Diagnosis Choices Available for RSD
Focus on the change in name and added laterality.  One of the most important part... Read more
Reader Question:
Can You Let NPP Rules Slide In This Situation?
Question: We sometimes need to collect preoperative information about a new patient... Read more
Reader Question:
Does Breach of Single Person's PHI Require Notification?
Question: What must we do in terms of breach notification if we mail a statement to... Read more
Reader Question:
Whom Do You Bill for Record Transfer Fees?
Question: Our practice discharged a patient due to non-payment, and one week later ... Read more
Reader Question:
How to Assign DRGs for Appendectomy
Question: A patient has to undergo appendectomy. She is anemic and obese. How shoul... Read more
You Be the Coder:
How Frequently to Ask Patients for ABN
Question: The practice I am associated with seems to ask patients for ABNs quite fr... Read more
Compliance:
Are You All Set To Grab The Incentives Of The EHR Program in 2015?
Acquire the 2014 edition CEHRT to participate.  Don’t have the 2014 edition... Read more
Who Can Participate
Hospitals Eligible for Medicare:  Subsection (d) hospitals" in the 50 sta... Read more
Timeline for EHR Incentives
Oct. 1, 2014: Beginning of the 2015 reporting period for eligible hospitals Nov. 30, 1... Read more
Accreditation:
How Strong are Your Patient Safety Standards?
Check out what Joint Commission solicits on the tenet “Do No Harm” It&rsqu... Read more
Act on These Must-Know Facts
Every patient safety event must be reported. When there is a continuous reporting, th... Read more
Compliance:
Upcoming Audits? Foolproof Your Documentation.
Learn from the 3 top targeted documentation mistakes people make. Your best defense wh... Read more
ICD-10 Update:
4 Must-Know Tips for Pain Management Under ICD-10
A keen eye on documentation and ‘excludes’ will see you through Understand... Read more
Reader Question:
Keep a Check on the Types of Patients You Treat in IRF
Question: What is the percent rule and how does it apply to the IRFs? Minnesota S... Read more
Reader Question:
Master Inpatient Electroconvulsive Therapy Reimbursement with ICD-9 Code 94.27
Question: How do I get reimbursed when a patient with psychiatric disorder receives... Read more
Reader Question:
Does Medicare Pay for a Screening Breast MRI?
Question: We have a Medicare patient that is BRCA2 positive. Our doctor wants a bre... Read more
Reader Question:
How Do the MDHs Get Paid?
Question: My provider renders service in a small, 75 bed Medicare Dependent Rural H... Read more
You Be the Coder:
Watch to Exclude Urinary Retention as a CC with BPH
Question: Urinary retention is on the standard CC list. Can we report it as such wh... Read more
Don't Wait:
Update Yourself on the Revised Diagnostic Imaging Standards for Hospitals.
Weigh in with your feedback to Joint Commission by Oct. 24. If you missed the Sept. 16... Read more
Patient Management:
Opioid Overuse in Inpatients Rises 150 Percent in the Last Two Decades: Have You Given In?
Know the facts and break the fall that “doctor shopping” has wrought How c... Read more
CPT® 2015 Update:
Prepare Now for a Terminology Upgrade for Gastro Endoscopy
Here’s how to keep abreast of current terminology and accurate codes. If your fa... Read more
ICD-10 Update:
Tackle the All-New ICD-10 Code for Renal Disease in Pregnancy
Remember to use an additional code to specify underlying disorder. ICD-10 codes for pr... Read more
Reader Question:
Get Credit for Audit Planning With MS-DRGs
Question: I am preparing for the audit of my facility. I heard that I can use the a... Read more
Reader Question:
Work With V72.5 While Coding X-ray for Comparison Views
Question: In a patient who incurred a leg injury following a car accident, the surg... Read more
You Be the Coder:
Know To Choose the Principal Diagnosis In Spondylolysthesis With MI
Question: A patient was admitted for the treatment of spondylolysthesis. Immediatel... Read more
Compliance:
Conditions Of Participation: Watch These 4 Areas Surveyors Are Targeting
 Prove you’ve implemented policies and have impeccable documentation CMS ha... Read more
Reimbursement:
Get Speedy Reimbursement When You Withdraw Claims Appeal, Says CMS
Acute care hospitals and CAHs need to apply before Oct. 31  If you work in an acu... Read more
Compliance:
Capture the Latest Updates in Hospital Standards by the Joint Commission
Hint: Watch for new requirements regarding provider eligibility and more Keeping abrea... Read more
ICD 10 Update:
Ace Coding for Ear Conditions With These 3 Quick Tips
Look out for laterality, sequencing and more. ICD-9 groups diagnosis codes for ear and... Read more
Reader Question:
Are Private Room Charges Covered?
Question: Some of the patients getting admitted to the hospital require a private r... Read more
Reader Question:
Coding Hospital Acquired Conditions With MS-DRG 185
Question: A patient admitted for major chest trauma later develops a pressure ulcer... Read more
Reader Question:
Here's How to Prove Medical Necessity in LTCHs
Question: How do you prove medical necessity in LTCHs and prevent the vicious cycle... Read more
Reader Question:
Choose Wisely Between 19301 And 19303 For Breast Surgery
Question: While performing the breast lumpectomy operation the provider decides to ... Read more
You Be the Coder:
Surgical Hierarchy Among MS-DRG 243 and 247
Question: If a patient with a major complication and comorbidity gets a permanent c... Read more
Compliance:
What You Must Know About CMS' New Conditions of Participation
Can’t-miss tips on CoPs for hospitals: standing orders, biologicals and more. CM... Read more
Billing:
Inpatient Trend Results Are In: How Does Your Facility Stack Up?
AHRQ projections indicate inpatient costs to rise 2 percent every year. One-third of a... Read more
ICD-10 Update:
Focus on Pancreatitis Pathology to Pick the Precise ICD-10 Codes
Shift focus from chronicity to pathology identification.  ICD-10 offers a variety... Read more
Case Study:
Remember 5 Points to Refine Your Tumor, Skin Replacement Coding
Plus: Keep this list of services included with skin substitute grafts.  The provi... Read more
Reader Question:
When Do You Start the Two-Midnight Count?
Question: A patient is seen in the ER and admitted to observation on 6/11/2014 at 1... Read more
Reader Question:
Seeing through the 3-day (or 1-day) payment window policy
Question: A 50-year -old patient is seen as an outpatient in the ED of a cancer hospital... Read more
Reader Question:
Brush Up On the Right Code for Ventilator Patient
Question: A patient is on a ventilator in the hospital ICU. Can the provider bill 9... Read more
Reader Question:
Who Gets to Bill for a Transferred Patient?
Question: Our hospital received a patient having seizures with MCC from another acu... Read more
You Be the Coder:
Do Not Apply Critical Care Codes on Basis of Location Alone
Question: After a patient with severe abdominal pain and hemoptysis in the ER was a... Read more
Compliance:
Focus on Terminology to Understand CMS' New Conditions of Participation
Start your CoPs success by understanding these implementation basics. CMS has laid dow... Read more
Billing:
Make the Most of Newly Released HHS Data on Hospitals Utilization Parameters
Take a look at how your competitors are billing.  If you’ve ever wondered h... Read more
Reimbursement:
Heads Up: Have the LTCHs Been Overpaid With Medicare's Interrupted–Stay Policy?
Know your facts on how CMS will scan LTCH reimbursement from now on. The HHS Office of... Read more
ICD-10 Update:
Take the Guesswork Out of Portal Hypertension Coding
Remember to look for additional complications in the documentation. When ICD-10 goes i... Read more
Reader Question:
Know The Site Of Injection Administration Well Before Reporting 20550
Question: When reporting CPT® 20550, should I report the code with bilateral mo... Read more
Reader Question:
Can 99144 and Epidural Injections Go Together
Question: One of our physicians adds 99144 to his billing sheet whenever he performs epi... Read more
Reader Question:
Coding for Nursemaid's Elbow
Question: Our provider treated a 4-year-old girl for nursemaid’s elbow after ... Read more
Reader Question:
Do Recurrent Laryngeal Nerve Schwannoma Coding With Precision
Question: I am unable to locate a CPT® code for excision of a recurrent larynge... Read more
You Be the Coder:
Know When To Code 50825 For Continent Diversion
Question: The code for Camey enterocystoplasty is 51960. As this is included in the... Read more
Observation Coding:
Don't Let Higher Dollars for Observation Services Catch You Off Guard
Look for higher payment but more packaging of services such as labs in 2014. Facilitie... Read more
Reimbursement:
Hold on to your dollars with CMS's inpatient payment regulations in 2015
Do realistic self analysis, and brace your facility to stay unaffected  CMS issue... Read more
The Joint Commission's Diagnostic Imaging Standards Roll Out Postponed Until July 2015
Wield your imaging edge by gauging your preparations Joint Commission (JCAHO) announce... Read more
ICD-10:
Section for AICD Codes Changes in 2015, But Descriptors Remain Mostly the Same
V45.01 and V45.02 will become Z codes. Sometimes a patient whose case you’re cod... Read more
Reader Question:
Get 60271 Right Every Time
Question: I’ve always considered 60271 to represent total removal, along with... Read more
Reader Question:
Know When 29837 Applies to Rotator Cuff Repair
Question: In one of our recent cases, the provider performed debridement of the gre... Read more
Reader Question:
Use Modifier 25 Scrupulously to Avoid Payer Scrutiny
Question: I need guidance on exactly how and when to separately report an E/M servi... Read more
Reader Question:
Bronchoscopy Coding Blues: 31622 or 31624?
Question: The provider’s documentation reads: “Diagnostic bronchoscopy ... Read more
Reader Question:
Code Facet Joint Cyst Aspiration With Ease
Question: The provider has performed facet joint aspiration for a facet cyst at rig... Read more
You Be the Coder:
Tackle Neck Dissection Codes the Right Way
Question: The neck dissections are surgically classified into radical neck dissecti... Read more
ICD-10-PCS:
Use the Extra ICD-10 Implementation Time To Address These Vital Issues
Tip: Lessons from global neighbors could help smooth your transition. With a five-fold... Read more
Patient Privacy:
Here's What Your Facility Can Learn From a Florida Security Breach Case
Tip: Following 6 steps can potentially keep you in the clear.  A recent settlemen... Read more
Patient Privacy:
Prepare Now for the Next Round of HIPAA Compliance Audits
Plus: Don’t make the same mistake this local government did. Get your staff thin... Read more
Reader question:
Don't Include Time as a Component in Your ED E/M Coding
Question:  A patient with a chronic gastric ulcer reports to the ED complaining of ... Read more
Reader Question:
Coding Observation Services? Get Complete PFSH
Question: Is it always required that a family history be documented before assignin... Read more
Reader Question:
Remember 93924 Includes Treadmill Testing
Question: Does the code 93924 include the charge for treadmill stress testing? Mi... Read more
Reader Question:
Understand the Difference Between 'Consent' and 'Authorization'
Question: What’s the difference between “consent” and “authoriza... Read more
Reader Question:
Submit Separate Codes for Surgery Treating New and Recurrent HNP
Question: Surgery was performed due to recurrent HNP (herniated nucleus pulposus) a... Read more
You Be the Coder:
Check This Before Billing Services for 2 Docs for Same Patient on Same Day
Question: I have a debate with our biller regarding   how to bill critical car... Read more
ICD-10 Update:
President Signs Bill That Includes ICD-10 Delay, Change to 2-Midnight Rule
Plus: Fee schedules stay the same, but physicians seek a permanent SGR formula revision.... Read more
E/M Care:
5 Simple Steps Teach All You Need to Know About Subsequent Hospital Care Coding
Practicing each of these steps may increase bottom line.  It’s easy to repo... Read more
HIPAA:
Don't Let Misunderstanding State Laws Complicate Your Mental Health Compliance
Hint: Remember that state laws trump HHS guidelines.  On Feb. 20, the Department ... Read more
Reader Question:
Focus on Regions for MRI Spine Survey
Question:  What would be the correct CPT® code(s) for an MRI spine survey? Ne... Read more
Reader Question:
Dealing With PHI When Laws Disagree With HIPAA
Question: What should we do when our state law requires restriction or withholding ... Read more
Reader Question:
Watch Suitability When Coding Bone Marrow Transplants
Question: How should we code if we perform HLA typing for multiple A and B antigens... Read more
You Be the Coder:
Global Days for Simple Laceration Repair
Question: I had a patient come in with a laceration that was repaired using a simpl... Read more
2-Midnight Rule:
How Should You Count 2-Midnight Claims? CMS Shares the Scoop
Counting time and medical necessity still lead the list of must-haves. Implementation ... Read more
Inpatient Therapy:
Heads Up: Hospitals Aren't Out of the Woods Yet on Therapy Cap Changes
Pathway for SGR Reform Act nails CAHs, but may be only temporary. The therapy cap poli... Read more
ICD-10:
Take 2 Steps to Pinpoint Best Vertebral Fracture Options Under ICD-10
Tip: Confirm underlying disease and site before you pick up the right code. Orthopedic... Read more
Compliance:
Keep Your HIPAA Policies In Line By Focusing On 4 Principles
Do your policies set forth clear responsibilities and accountability? Every physician ... Read more
Reader Question:
Capture Consult and Special Stains
Question:  When we receive a tissue block for consultation and prepare additional H... Read more
Reader Question:
Handling Provider Hand-Off in the ED
Question:  If a patient is seen by two different docs in ED, one starts treatment t... Read more
Reader Question:
Follow HIPAA for Guidelines on Keeping Medical Records
Question:  How long do we need to keep medical records? Iowa Subscriber  A... Read more
Reader Question:
Gastrostomy Tube Change Leads to 43760
Question:  A patient presented with a partially dislocated gastrostomy tube with pa... Read more
Reader Question:
Remember Modifier -58 for Staged Pilon Fracture Treatment
Question:  Our surgeon stabilized a pilon fracture using an external fixator and op... Read more
You Be the Coder:
Encounters vs. Days for Inpatient Visit Coding
Question: A Medicare inpatient was aggressive and needed restraints several times d... Read more
Inpatient Admissions:
Get the Facts on 'Unforeseen Circumstances' vs. 'Exceptions' to 2-Midnight Rule
Here’s the scoop from the latest CMS provider call. The FY 2014 Inpatient Prospe... Read more
Cardiology:
Don't Miss This Big Change to Non-Selective Renal Angiography Coding
Updated code use is retroactive to DOS for Jan. 1, 2014 and later. CMS recently posted... Read more
ICD-10-PCS:
Follow 3 Steps to Change Your Transplant Coding in 2014
Hint: Focus on allogeneic, syngeneic, and zooplastic to choose the best 7th character. ... Read more
Reader Question:
Check 89060 for Polarizing Microscopy Service
Question: The pathologist examined a bursa fluid aspirate smear from the left elbow, ide... Read more
Reader Question:
Let Documentation Guide Your Selection of Principal Diagnosis
Question: A patient was admitted through the Emergency Department with fluid overload. H... Read more
Reader Question:
Laparoscopic Salpingectomy Reverts to Open Code
Question: I’m coding for a patient who had a laparoscopic salpingectomy, but am no... Read more
Reader Question:
Use Time Documentation to Determine Critical Care, CPR, or Both
Question: A 65-year-old disabled patient presented to the ED with nausea, vomiting, and ... Read more
Reader Question:
Counting Down Until Windows XP Won't Be HIPAA Compliant
Question: One of our IT managers said the hospital won’t be able to use Windows XP... Read more
Reader Question:
Start With 20680 for Screw Extraction
Question: An orthopedic surgeon’s note states, “Previous incisions incised..... Read more
You Be the Coder:
Criteria for Changing Patient Status
Question: A patient was formally admitted as an inpatient, per physician orders. The Uti... Read more
Joint Commission:
Prepare Now for New and Revised Diagnostic Imaging Standards
Changes to be implemented in two phases beginning July 2014. Diagnostic imaging standa... Read more
Reimbursement:
ED Facility Levels Are Safe From Cuts in 2014
Good news: Payment levels also increase in 2014 OPPS final rule. Emergency Department ... Read more
Clip and Save:
Here's Your Handy Guide to 2014 ED Facility Reporting
Hint: Clinic visit coding gets streamlined. The table below summarizes the facility re... Read more
2014 Billing:
Watch These CMS Instructions When Part B Inpatient Billing Applies
Tip: Timely filing is your first hurdle to conquer. The Federal Register outlining IP... Read more
Reader Questions:
Begin With 428.0 for Congestive Heart Failure
Question: A patient was admitted with chest pain and diagnosed with congestive heart fai... Read more
Reader Questions:
Stick With Single Code When Same Mesh Covers Two Hernias
Question: I’m coding for a laparoscopic inguinal hernia repair (right side) for a ... Read more
Reader Questions:
Watch for Difference Between First Round TURP and Repeat Laser
Question: A patient underwent laser vaporization of a portion of the prostate (52648) by... Read more
Reader Questions:
Steer Clear of Modifier 25 for PTs
Question: Do you know if Medicare requires modifiers to be in a specific order? For exam... Read more
Reader Questions:
Get Familiar With Different Characters for Some ICD-10-PCS Coding
Question: I know that the diagnosis codes under ICD-10-PCS will have seven characters an... Read more
You Be the Coder:
Fractured Surgical Neck of Humerus
Question: A patient fell while intoxicated and was admitted because of a fractured humer... Read more
Available Years:  2014  2013  2012