Understand how losing subcategory V64.4x will affect reporting of converted surgical approaches. By Jennifer E. Avery, CPC-H, CPC, CPC-I, CCS The Centers for Medicare & Medicaid Services (CMS) instructs us that when a procedure begins by laparoscopic approach, but must be converted to (and completed by) open approach, only the open approach is coded. In ...
In Audit
Jun 1st, 2012
The Centers for Medicare & Medicaid Services (CMS) has posted on its website the MLN Quarterly Provider Compliance Newsletter for April. The top billing errors for this month, detected by Comprehensive Error Rate Testing (CERT) and recovery auditors, all pertain to inpatient hospitals. Three-day Rule At the top of the list is a CERT finding ...
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) ...
Jul 1st, 2010
By Marcella Bucknam, CPC, CPC-H, CPC-P, CPC-I, CCC, COBGC, CCS, CCS-P A pancreaticoduodenectomy, pancreatoduodenectomy, or Whipple, is a surgical procedure involving the pancreas, intestines, and other organs. It is usually performed to treat malignancies on the head of the pancreas, common bile duct, or duodenum (which are near the pancreas) but also may be performed ...