OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC DRG Code 804

If you’re feeling the heat of state fraud scrutiny, you are not alone. Home health agencies had the third-most open fraud investigations with Medicaid Fraud Control Units in 2020 at 804, the HHS Office of Inspector General says in a [...]

Question: Encounter notes specify only that the provider performed “extensive undermining” during a 4.6-cm trunk repair. Is this enough documentation to report a complex closure code? Georgia Subscriber Answer: That’s a tough question; extensive undermining certainly translates into at least an intermediate [...]

Plus: Don’t forget you have different codes for posterior bleeds. A patient comes to your office complaining of a persistent nosebleed. Your physician stops the bleed, but that doesn’t mean you stop looking at code choices once you reach 30901 [...]

Plus: Don’t forget you have different codes for posterior bleeds. A patient comes to your office complaining of a persistent nosebleed. Your physician stops the bleed, but that doesn’t mean you stop looking at code choices once you reach 30901 [...]

Another payment update, another significant case mix revision. Get ready for your bottom line to look significantly different, depending on your patient mix. Reminder: In its 2015 prospective payment system proposed rule, the Centers for Medicare & Medicaid Services proposes [...]

Rule out some specific types before you jump over to ‘other’ seizures. Not able to categorize epilepsy? Currently, you’ll submit your claim with ‘Other forms of epilepsy’ or ‘unspecified epilepsy,’ depending upon your neurologist’s documentation. ICD-10 offers you an advantage [...]

Proving services unrelated to terminal Dx may get harder. It may be wise to beef up your documentation for services your hospice patients receive that aren't related to the terminal diagnosis. Under Medicare payment rules, the hospice per diem payment [...]

Medical practices raked in millions in 2009, thanks to incentives from the Physician Quality Reporting System (PQRS) and ePrescribing Incentive Program, a new report indicates.On April 19, CMS released its "2009 Physician Quality Reporting System and ePrescribing Experience Report," which [...]

Screening for elevated levels of fear-avoidance beliefs regarding work or physical activities in people receiving outpatient therapy. Hart DL, Werneke, MW, George SZ, Matheson JW, Wang YC, Cook KF, Mioduski JE, Choi SW. Phys Ther. 2009 Aug;89(8):770-85. A simple pre-treatment [...]

Question: Should I report the LOCM Q codes for exams performed in a hospital setting?Indiana Subscriber Answer: If you're coding for the cardiologist ...quot; not the hospital ...quot; you shouldn't report low osmolar contrast material (LOCM) codes Q9945-Q9951, because the [...]