In Billing
May 23rd, 2018
Starting Oct. 1, hospital discharges to hospice care qualify as a post-acute care transfer and may have payment adjustments for Medicare patients. According to the Centers for Medicare & Medicaid Services (CMS) Transmittal 2055, change request 10602, under the policy regulations § 412.4: * When a patient is transferred to another hospital and their stay ...
In Audit
Dec 16th, 2016
In inpatient auditing, you are auditing ICD-10-CM diagnosis codes, ICD-10-PCS procedures codes, and much more. The purpose of inpatient auditing is to ensure that the correct DRG was assigned. All of the following factors play a role in making sure the correct inpatient reimbursement is received: 1. Assignment of the principal diagnosis – If you ...
In Coding
Jun 16th, 2016
Interactions between providers and patients, staff and patients, and providers and hospital employees play a major role in how patients perceive their hospital or physician visits. There are several ways to ensure that the patient is having a positive experience. Here are four areas to focus on to improve patient experience.       Implement ...
May 28th, 2015
Incorrect patient discharge status codes have been identified by the Recovery Audit Contractors (RACs) as a contributor to hospital underpayments and overpayments. The solution is an understanding of the Medicare Post Acute Care Transfer (PACT) policy. CMS requires patient discharge status codes for hospital inpatient claims, skilled nursing claims, outpatient hospital services, and all hospice ...
Dec 1st, 2012
By Catrena Smith, CPC, CCS, CCS-P, and Elizabeth Giustina, CCS-P  A common misconception is that hospital coding is synonymous with inpatient coding, but hospitals provide many services in addition to inpatient care. Hospital coders may find themselves coding for different settings, such as the facility’s outpatient clinics, emergency department (ED), urgent care center, ambulatory surgery ...