OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC DRG Code 515

Plus: IDR proposal should be in home health rule with SFP provision. Medicare hasn’t even finalized the HOPE assessment tool yet, but it’s already making plans for the data the patient assessment tool will produce. In its April 19 Open [...]

Mode experiment results give hospices a clue. Keep an eye on future hospice rules to see whether the way CAHPS surveys are administered will get a revamp. The Centers for Medicare & Medicaid Services has released results from its 2021 [...]

Don’t underestimate the importance of proving medical necessity. If you’re waiting for the feds to lighten up their fraud-fighting efforts, you’ll be waiting a long time. A new report highlights audits and investigations — and the numbers are staggering. In [...]

Report highlights importance of medical necessity. If you’ve ever wondered whether the U.S. Department of Health and Human Services Office of Inspector General (OIG) collects on its audits and investigations, a new report answers that question — and the numbers [...]

Documentation determines choice between E/M and ventilation management coding. You may be missing out on deserved reimbursement dollars for your pulmonologist’s respiratory failure treatments if you do not pay attention to the method of ventilation management, location of care, and [...]

Documentation determines choice between E/M or ventilation management coding You may be missing out on deserved reimbursement dollars for your pulmonologist’s respiratory failure treatments if you do not pay attention to the method of ventilation management, location of care, and [...]

Coagulation factor deficiency coding requires a look at the index.ICD-10-CM code D68.4 has the same definition as ICD-9-CM code 286.7. That's not the end of the coding story, though. Here's how D68.32 fits into the picture, too.ICD-9-CM code:286.7, Acquired coagulation [...]

Question: Our patient has ovarian cancer and is receiving chemotherapy at her doctor's office. She also has chronic interstitial lung disease, a urinary tract infection (UTI), a colostomy, osteoarthritis in her knee, an alteration in gait, and deep vein thrombosis in [...]

When it comes to Medicare's Comprehensive Error Rate Testing (CERT) reports, the agency tells it like it is -- and CMS found four major errors among outpatient rehabilitation therapy service claims. According to the new fact sheet entitled, "Comprehensive Error Rate [...]

If you haven't had to revalidate your Medicare enrollment yet, you will soon. "Between now and March 23, 2013, MACs will send out notices on a regular basis to begin the revalidation process for each provider and supplier," HHH MAC [...]