High-profile cases paint industry with fraud brush. The hospice industry continues to draw fraud-fighting attention from the feds, as shown in a recent report on the Health Care Fraud and Abuse Control Program operated jointly by the OIG and DOJ. [...]
The industry is still living down the Dr. Jacques Roy case. Don't expect fraud and abuse scrutiny to let up any time soon, with the HHS Office of Inspector General reporting $2.4 billion in judgements and settlements in fiscal year [...]
Look for Total Body Surface Area (TBSA) documentation in notes. Look for three things in the documentation to accurately report burn presentations diagnosis codes. The guidelines in both ICD-9-CM and ICD-10-CM direct you to consider the anatomical location of the [...]
Tip: Focus on degree and percentage affected. An insight to types of burns and a summarization of 4-step procedure to code your burned cases will help in smooth reimbursement process. Dig Into the Depth and Degree of Burn There are [...]
Question: Can we use 99479 for a newborn (34 weeks estimated gestational age) that has a weight of 2,948 grams and is on day 31 of the hospital stay? I can’t tell if that code is for only 28 weeks [...]
ICD-10 will keep additional TBSA code. The steps you’ll take to code for burns in ICD-10 aren’t all that different from the ones you follow under ICD-9. But you will have the new requirement to include a code that describes [...]
Question: Our dermatologist treats burn victims, and I'm wondering about diagnosis coding in these cases. Do I need to include a code from category 948 on every claim? Michigan Subscriber Answer: Yes. Once you locate code(s) to represent the patient's [...]
Question: We are providing physical therapy for gait training for a patient who also has a pair of burns. She has a second-degree burn on her right wrist and a first-degree burn on the back of her right hand. How [...]
Question: We are providing physical therapy for gait training for a patient who also has a pair of burns. She has a second-degree burn on her right wrist and a first-degree burn on the back of her right hand. How [...]
Question: A parent brings a 9-year-old child into the ED with blistering burns to the left side of her body. After a level-four E/M, the ED physician treats the child for partial-thickness burns on her entire left arm and left [...]
