And find out how to code an unsuccessful procedure. While many women prefer to see a gynecologist to discuss and manage their cycles, many choose instead to see their primary care practitioner (PCP). This means that many family medicine practices [...]
2 agencies pay millions in back wages and damages. Wage and hour-based cases continue to stack up against home care providers. January case #1: A federal judge has ordered TriMED HealthCare LLC and its owner Beverly Jordan to pay more [...]
Don’t overlook your diagnosis coding selection. When an ob-gyn attempts to place an intrauterine contraceptive device (IUD) and is unsuccessful, you’re often the one left with a quandary. What modifier should you include? The answer may depend on whose advice [...]
Always report the code with the highest level of specificity, based on documentation. October 1 brings the next round of ICD-10-CM codes to both software and manuals, and if you’re not prepared, your claims could end up in limbo — [...]
CMS is not following the law’s intent, lawmakers tell Verma. Four influential lawmakers have home health agencies’ backs when it comes to behavioral assumption cuts in the first year of the Patient-Driven Groupings Model. The Centers for Medicare & Medicaid [...]
PDGM rate reduction necessary, Commission says. If you’re hoping the imminent Home Health Prospective Payment System proposed rule for 2020 will contain an elimination of the so-called behavioral adjustment rate cut for the Patient-Driven Groupings Model, a look back at [...]
Members of Congress have introduced a bill in the House that would head off the behavioral adjustment payment reduction in the Patient-Driven Groupings Model. Sen. Susan Collins (R-Maine) introduced a version of the bill in the Senate in February. The [...]
HHAs have only months to secure legislative change. The home health industry is fighting to head off Patient-Driven Groupings Model pay rate cuts that will also take effect in January. In the 2019 final rule, the Centers for Medicare & [...]
Tip: Ensure your coders get all the documentation upfront. You could face charges of overpayment — and even deliberate fraud — if your documentation doesn’t hold up to scrutiny after your claims are paid. Don’t assume certain details are unnecessary [...]
Misunderstood documentation could lead to accusations of overpayments. It’s been said that communication is the key to success in love, in business, and more than ever, in medicine. The how, what, when, where, and why of documenting care is directly [...]
