[Facility] Stand up to scrutiny by ensuring key components are included in patient documentation. By Heather Greene, MBA, RHIA, CPC, CPMA The Centers for Medicare & Medicaid Services (CMS) will conduct prepayment patient status probe reviews for dates of admission between October 1, 2013 and March 31, 2015 using a “probe and educate” format. In ...
Coding Compass: Facility A revision to the 2014 IPPS final rule helps to clarify the “two-midnight” rule. By Julie E. Chicoine, Esq., RN, CPC, CPCO All too often, chronically ill, medically fragile patients present to a hospital’s emergency department (ED) or outpatient clinic with exacerbation of chronic problems the patient and family members cannot manage alone. ...
Feb 1st, 2014
Review common scenarios to get the big picture of observation status requirements. By Kerin Draak, MS, RN, WHNP-BC, CPC, CPC-I, CEMC, COBGC and G.J. Verhovshek, MA, CPC Coding for observation services depends on several variables, including the time a patient spends in observation care and whether he or she is subsequently admitted as an inpatient. A review ...
Jun 1st, 2013
Find out how a new ruling and a proposed rule will affect your claims processing. By Stacy Harper, JD, MHSA, CPC Due to a recent controversy in claims payment, the Centers for Medicare & Medicaid Services (CMS) issued Ruling 1455-R on March 13 and a proposed rule on March 18. The rules substantially affect how ...
May 1st, 2012
Better Documentation + Better Compliance = Better Quality of Care By Richard Skaff Behavioral health has struggled with regulatory compliance, including documentation, billing and coding, treatment plans, and medical necessity. A “top down” approach to address shortcomings in behavioral health practice and diagnostics is the ultimate solution, but common sense and improved documentation will go ...