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Inpatient Facility Coding & Compliance Alert
Inpatient Facility Coding & Compliance Alert
Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 12
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...
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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...
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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...
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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...
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Reader Question:
Can You Let NPP Rules Slide In This Situation?
Question: We sometimes need to collect preoperative information about a new patient...
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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...
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Reader Question:
Whom Do You Bill for Record Transfer Fees?
Question: Our practice discharged a patient due to non-payment, and one week later ...
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Reader Question:
How to Assign DRGs for Appendectomy
Question: A patient has to undergo appendectomy. She is anemic and obese. How shoul...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 11
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...
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Who Can Participate
Hospitals Eligible for Medicare: Subsection (d) hospitals" in the 50 sta...
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Timeline for EHR Incentives
Oct. 1, 2014: Beginning of the 2015 reporting period for eligible hospitals Nov. 30, 1...
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Accreditation:
How Strong are Your Patient Safety Standards?
Check out what Joint Commission solicits on the tenet “Do No Harm” It&rsqu...
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Act on These Must-Know Facts
Every patient safety event must be reported. When there is a continuous reporting, th...
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Compliance:
Upcoming Audits? Foolproof Your Documentation.
Learn from the 3 top targeted documentation mistakes people make. Your best defense wh...
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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...
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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...
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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...
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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...
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Reader Question:
How Do the MDHs Get Paid?
Question: My provider renders service in a small, 75 bed Medicare Dependent Rural H...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 10
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...
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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...
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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...
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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...
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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...
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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...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 9
Compliance:
Conditions Of Participation: Watch These 4 Areas Surveyors Are Targeting
Prove you’ve implemented policies and have impeccable documentation CMS ha...
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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...
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Compliance:
Capture the Latest Updates in Hospital Standards by the Joint Commission
Hint: Watch for new requirements regarding provider eligibility and more Keeping abrea...
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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...
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Reader Question:
Are Private Room Charges Covered?
Question: Some of the patients getting admitted to the hospital require a private r...
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Reader Question:
Coding Hospital Acquired Conditions With MS-DRG 185
Question: A patient admitted for major chest trauma later develops a pressure ulcer...
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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...
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Reader Question:
Choose Wisely Between 19301 And 19303 For Breast Surgery
Question: While performing the breast lumpectomy operation the provider decides to ...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 8
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...
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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...
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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...
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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...
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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...
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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...
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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...
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Reader Question:
Who Gets to Bill for a Transferred Patient?
Question: Our hospital received a patient having seizures with MCC from another acu...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 7
Compliance:
Focus on Terminology to Understand CMS' New Conditions of Participation
Start your CoPs success by understanding these implementation basics. CMS has laid dow...
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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...
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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...
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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...
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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...
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Reader Question:
Can 99144 and Epidural Injections Go Together
Question: One of our physicians adds 99144 to his billing sheet whenever he performs epi...
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Reader Question:
Coding for Nursemaid's Elbow
Question: Our provider treated a 4-year-old girl for nursemaid’s elbow after ...
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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...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 6
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...
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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...
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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...
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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...
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Reader Question:
Get 60271 Right Every Time
Question: I’ve always considered 60271 to represent total removal, along with...
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Reader Question:
Know When 29837 Applies to Rotator Cuff Repair
Question: In one of our recent cases, the provider performed debridement of the gre...
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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...
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Reader Question:
Bronchoscopy Coding Blues: 31622 or 31624?
Question: The provider’s documentation reads: “Diagnostic bronchoscopy ...
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Reader Question:
Code Facet Joint Cyst Aspiration With Ease
Question: The provider has performed facet joint aspiration for a facet cyst at rig...
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You Be the Coder:
Tackle Neck Dissection Codes the Right Way
Question: The neck dissections are surgically classified into radical neck dissecti...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 5
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...
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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...
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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...
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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 ...
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Reader Question:
Coding Observation Services? Get Complete PFSH
Question: Is it always required that a family history be documented before assignin...
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Reader Question:
Remember 93924 Includes Treadmill Testing
Question: Does the code 93924 include the charge for treadmill stress testing? Mi...
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Reader Question:
Understand the Difference Between 'Consent' and 'Authorization'
Question: What’s the difference between “consent” and “authoriza...
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Reader Question:
Submit Separate Codes for Surgery Treating New and Recurrent HNP
Question: Surgery was performed due to recurrent HNP (herniated nucleus pulposus) a...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 4
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....
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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...
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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 ...
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Reader Question:
Focus on Regions for MRI Spine Survey
Question: What would be the correct CPT® code(s) for an MRI spine survey? Ne...
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Reader Question:
Dealing With PHI When Laws Disagree With HIPAA
Question: What should we do when our state law requires restriction or withholding ...
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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...
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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...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 3
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 ...
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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...
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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...
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Compliance:
Keep Your HIPAA Policies In Line By Focusing On 4 Principles
Do your policies set forth clear responsibilities and accountability? Every physician ...
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Reader Question:
Capture Consult and Special Stains
Question: When we receive a tissue block for consultation and prepare additional H...
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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...
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Reader Question:
Follow HIPAA for Guidelines on Keeping Medical Records
Question: How long do we need to keep medical records? Iowa Subscriber A...
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Reader Question:
Gastrostomy Tube Change Leads to 43760
Question: A patient presented with a partially dislocated gastrostomy tube with pa...
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Reader Question:
Remember Modifier -58 for Staged Pilon Fracture Treatment
Question: Our surgeon stabilized a pilon fracture using an external fixator and op...
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You Be the Coder:
Encounters vs. Days for Inpatient Visit Coding
Question: A Medicare inpatient was aggressive and needed restraints several times d...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 2
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...
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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...
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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. ...
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Reader Question:
Check 89060 for Polarizing Microscopy Service
Question: The pathologist examined a bursa fluid aspirate smear from the left elbow, ide...
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Reader Question:
Let Documentation Guide Your Selection of Principal Diagnosis
Question: A patient was admitted through the Emergency Department with fluid overload. H...
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Reader Question:
Laparoscopic Salpingectomy Reverts to Open Code
Question: I’m coding for a patient who had a laparoscopic salpingectomy, but am no...
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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 ...
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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...
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Reader Question:
Start With 20680 for Screw Extraction
Question: An orthopedic surgeon’s note states, “Previous incisions incised.....
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You Be the Coder:
Criteria for Changing Patient Status
Question: A patient was formally admitted as an inpatient, per physician orders. The Uti...
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Inpatient Facility Coding & Compliance Alert - 2014; Volume 3, Number 1
Joint Commission:
Prepare Now for New and Revised Diagnostic Imaging Standards
Changes to be implemented in two phases beginning July 2014. Diagnostic imaging standa...
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Reimbursement:
ED Facility Levels Are Safe From Cuts in 2014
Good news: Payment levels also increase in 2014 OPPS final rule. Emergency Department ...
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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...
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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...
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Reader Questions:
Begin With 428.0 for Congestive Heart Failure
Question: A patient was admitted with chest pain and diagnosed with congestive heart fai...
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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 ...
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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...
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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...
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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...
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You Be the Coder:
Fractured Surgical Neck of Humerus
Question: A patient fell while intoxicated and was admitted because of a fractured humer...
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Available Years:
2014
2013
2012