Agencies in Texas, Louisiana, Pennsylvania, Maryland, and Arizona caught up in the latest enforcement sweep. It’s not your imagination — Wage and Hour violations by home care providers have been in the enforcement spotlight more than ever. For example: A [...]
Learn how the point ranges will change to earn each star rating. It seems like the Centers for Medicare & Medicaid Services (CMS) has gone crazy for quality data, and now you have a whole set of new quality measures [...]
Is your payer’s advice lacking? Here’s how to create internal guidelines for chronic/acute conditions. Upgrading a rotator cuff strain to a torn rotator cuff can land your claim in troubled waters, especially as local carrier direction can be nonexistent. If [...]
Is your payer’s advice lacking? Here’s how to create internal guidelines for chronic/acute conditions. Upgrading a rotator cuff strain to a torn rotator cuff can land your claim in troubled waters, especially as local carrier direction can be nonexistent. If [...]
5 strategies keep complications out and reimbursement in. With ICD-10 delayed yet another year, it may be a good time to polish your ICD-9 late effects coding skills. Not only will this help improve your reimbursement when addressing and treating [...]
Question: A patient was treated for a fracture of the second metatarsal. Four weeks later, an X-ray revealed that the fracture had failed to heal at all. How should I code for the condition of non-healing metatarsal? California Subscriber Answer: A delayed [...]
Question: A patient who was treated for a closed pelvic ring/pubic ramus fracture visited scheduled an appointment with practice. Our physician treated her with a steroid injection for pain relief (it’s been four months since the original injury but this [...]
Question: A patient who was treated for a closed pelvic ring/pubic ramus fracture visited scheduled an appointment with practice. Our physician treated her with a steroid injection for pain relief (it’s been four months since the original injury but this [...]
Watch for changes to malunions and nonuinions. One of the biggest diagnosis coding changes you’ll notice in ICD-10 is in the way you’ll report fractures. Get ready to use all seven characters, and to stop using the old familiar aftercare [...]
Question: One of our patients presented because he’s experiencing neck pain that generated from an area of the spine where he suffered a previous injury. How should I code the diagnosis? Answer: Document and code prior conditions that contribute to [...]
