Notice of Admission content still in flux. When RAPs go away, Medicare wants home health agencies to substitute another kind of submission — a Notice of Admission. Home health agencies are opposing that proposed change, except perhaps if it stays [...]
Medicare uses 5 data measures to identify providers for scrutiny. If you serve a lot of patients with a primary diagnosis of diabetes or hypertension, you may have wound up on the feds’ radar. Why? In a new report, the [...]
Question: We are wondering how to code for this fecal disimpaction encounter. The doctor performed the disimpaction on an elderly patient after administering a moderate sedative. ED notes suggest a level 4 E/M service. How should we report the encounter, and [...]
Tip: Heeding local payer criteria for testing is crucial for getting paid. If you gastro reports H. pylori tests, you’ll need to ensure that you know when you are eligible to claim the tests, how to report various aspects of [...]
Tip: Keep in mind that payers may vary widely on this topic. If you gastro reports H. pylori tests, you’ll need to ensure that you know when you are eligible to claim the tests, how to report various aspects of [...]
The cost of preparing for the ICD-10 upgrade is far less than originally thought. Opinions at a Feb. 10, 2015 Energy and Commerce subcommittee hearing tipped the scale toward no more ICD-10 delays. If the final decision follows suit, it [...]
Hint: Distinguish from duodenal ileus to correctly nail the diagnosis. When you begin using ICD-10 codes after Oct.1, 2014, you’ll continue to report a diagnosis of gallstone ileus without much deviation from the way you reported this diagnosis with ICD-9 [...]
Don’t hesitate to get back to your provider for details when you need them. You might from time to time come across a claim with no supporting diagnosis—if your gastroenterologist has not provided you with a final diagnosis, you should [...]
In Table 3 of the 2014 Home Health PPS Final Rule, the Centers for Medicare & Medicaid Services lists the deleted codes most used in 2012. The top deleted codes used were: 1. 401.0 (Malignant essential hypertension), 34,207 episodes; 2. [...]
Examine your claims to make sure you’re using these codes correctly. In Table 3 of the 2014 Home Health PPS Final Rule, the Centers for Medicare & Medicaid Services lists the deleted codes most used in 2012. The top deleted [...]
