ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC DRG Code 280

Question: My ob-gyn sees a patient who has breast implants or breast augmentation and orders a mammogram. Should I count the mammography as a screening or a diagnostic test? Louisiana Subscriber Answer: Implants and augmentation don’t equate to a diagnostic [...]

LUPA threshold decreases far outweigh increases for next year. While halving the massive productivity payment cut is the major reimbursement provision of the 2023 home health final rule, other requirements will also impact home health agencies’ payments. For example: The [...]

Plus: CMS pulls back on outliers a tad. The 2023 home health proposed rule contains more reimbursement-impacting provisions than the draconian behavioral adjustment cut — some expected, some less so. As in 2023 proposed payment rules for other provider types [...]

Here’s how to navigate the Medicare minefield. For such a significant, high volume, yet simple procedure, mammograms generate an awful lot of coding questions. Chief among them are questions about the different reasons for the procedure, how and why Medicare [...]

Monitor developments for your lab. With COVID-19 pandemic information changing daily, use this snapshot of laboratory coding and regulatory information as a toolkit to help launch you into April. You’ll also find resource links to help you stay current in [...]

CMS encourages hospitals to highlight quality, cost info for referrals. The new discharge planning requirements for home health agencies aren’t the only ones affecting home care providers. Hospital provisions in the rule will impact HHAs, too. The discharge planning final [...]

Question: My ob-gyn sees a patient who has breast implants or breast augmentation and orders a mammogram. Should I count the mammography as a screening or a diagnostic test? Louisiana Subscriber Answer: Implants and augmentation don’t equate to a diagnostic [...]

Your own stats may put reviewers on your case. If you don’t want to land on medical review, you’d better check to see whether your non-cancer length of stay figures are making you stick out like a sore thumb. In [...]

MAC issues NCLOS comparative billing report. Regulators and reviewers are zeroing in on hospices and their patients with non-cancer diagnoses. Find out if you stick out like a sore thumb by using new benchmarks issued by one HHH Medicare Administrative [...]

Warning: Unresolved RAP issues can land you in a fraud contractor’s crosshairs. If you’re not careful with RAPs, you could end up slowing your cash flow significantly. To avoid negative consequences from Medicare’s new focus on Request for Anticipated Payment [...]