Jun 1st, 2012
Here’s what to do when your provider’s documentation takes a back seat. By Robyn Margani, CPC If it isn’t documented, it wasn’t done. That’s the golden rule of coding. As we’ve all been told again and again, inaccurate documentation can lead to improper payments, non-compliance with government and insurance regulations, and audit risks. Unfortunately, the ...
Jun 1st, 2012
2012 introduces new codes for both diagnostic and surgical VATS. By Laurette Pitman, RN, CPC-H, CGIC, CCS Due to advances in surgical procedures, video-assisted thoracoscopic surgery (VATS) has an increasing role in the diagnosis and treatment of a wide variety of thoracic disorders that previously required sternotomy or open thoracotomy. Patients who undergo this procedure ...
In Audit
Oct 1st, 2010
The Centers for Medicare & Medicaid Services (CMS) recently released two special edition MLN Matters articles that disseminate high dollar improper payment and coding vulnerabilities identified during the Recovery Audit Contractor (RAC) demonstration. With the expansion of the RAC program and the initiation of complex medical necessity review in all four RAC regions, inpatient hospitals ...
In Audit
Aug 27th, 2010
DCS Healthcare, recovery audit contractor (RAC) for Region A, posted 11 newly approved audit issues on its website mid-August. Unlike its counterpart, CGI Federal, none of the new issues include medical necessity review. Nine of the new issues are for medical severity-diagnosis related groups (MS-DRGs), another also affects inpatient claims and another affects durable medical equipment (DME) ...
Apr 1st, 2008
Here’s What to Do … By Nancy Reading RN, BS, CPC, CPC-I A member recently inquired, “Where can I safely count clubbing of the fingers on physical examination?” This question begs an issue that faces coders every day. We think we know the answer because that’s how we always do it, or that is how ...