Leverage test results to predict risk. If you never thought about how your hospital lab can help meet goals for the Hospital Readmissions Reduction Program (HRRP) that is part of the Affordable Care Act, think again. With $17 billion in [...]
Currently, Medicare spends approximately $17 billion annually in avoidable hospital readmissions that occur within 30 days of the original visit. With such a hefty price tag, CMS has been determined to turn around those dismal and costly statistics. Through ACA [...]
Watch out: Hospice-specific RAC in the works. Expect increased scrutiny of General Inpatient care following an HHS Office of Inspector General report claiming hospices widely overbilled for the service. The OIG reviewed 565 GIP stays from 2012 and deemed 31 [...]
Watch out: Hospice-specific RAC in the works. Expect increased scrutiny of General Inpatient care following an HHS Office of Inspector General report claiming hospices widely overbilled for the service. The OIG reviewed 565 GIP stays from 2012 and deemed 31 [...]
Question: Our surgeon performed Botox injections to treat anal fissures. How should I code this, and does Medicare cover it? Codify Subscriber Answer: Some MACs provide payment for using Botulinum toxin type A, usually called Botox, to treat anal fissures (ICD-9, 565.0, [...]
Question: We have a new gastroenterologist who recently advised Botox to a patient for treatment of anal fissures and to treat achalasia. Does Medicare reimburse for Botox injections for the treatment of anal fissures? How should I code the scenarios if [...]
Question: What is an anal fistula and what code should I use todescribe it?Washington, D.C. SubscriberAnswer: You should report 565.1 (Anal fistula) to describe this diagnosis. This condition pertains to a small tunnel forming under the skin that connects a [...]
Plus: Add this new botulinum drug to your coding toolbox.The Medicare Physician Fee Schedule will introduce some changes April 1 that could have a big effect on your practice's bottom line, especially if you code for a pain management specialist [...]
Keep compliant with new status indicators and codes.The Medicare Physician Fee Schedule will introduce some changes April 1 that could have a big effect on your practice's bottom line, especially if your provider uses chemodenervation to treat patients.Bilateral Indicator Shifts [...]
Question: I am a bit confused by this op report: A patient with external hemorrhoids and an anal fistula reports for "papillae destruction in 3 areas near anus." How do I code this procedure? Iowa Subscriber Answer: There is a [...]
