View the ICD-9 code's corresponding Diagnosis Related Groups (DRGs). In a click, verify the DRG, its IPPS allowable, length of stay, and more. Protect your facility's payments by subscribing to DRG Coder.
First, Humana DID pay 80%. It's 80% of the allowed amount, not 80% of billed charges. $763.96 x 80% = $611.17.
But here's the thing... unless it is in the deductible period at the beginning of the ... [ Read More ]
Any advice would be appreciated.
I have an example of a patient that has Humana Medicare Replacement as primary and Medicaid as secondary. Billed amount $2,150. Humana allowed $763.96 and paid $611.17... [ Read More ]
[B]Procedures:
INCISION AND DRAINAGE OF ABSCESS WITH REMOVAL OF FOREIGN BODY[/B]: The plantar surface of the right foot was cleansed with Betadine swab sticks ×3. No local anesthesia was used. Th... [ Read More ]
Per NCD 20.15 its not covered for routine other than the initial welcome to medicare visit.
[QUOTE][COLOR=#000000][FONT="]There is no coverage for EKG services when rendered as a screening test o... [ Read More ]
[QUOTE="elizabethcaste, post: 426935, member: 344648"]How do you code a patient that is coming for therapy services and dx is status post rt shoulder arthroplasty?[/QUOTE]
Didn't see any replies, so ... [ Read More ]
[QUOTE="Chelsea1, post: 410292, member: 166144"]I do not know which stent code to use for the following portion of this report;
Using a LIMA guiding catheter, the ostium of the LIMA graft was cannuli... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
A provider has asked the following question - There are different codes for follow-up paps when someone has had an abnormal one. There are the abnormal cytology ones R87.610, .611, .612, .613. Then th... [ Read More ]
[QUOTE="kseverson, post: 402961, member: 40199"]I am a certified coder. In my current job, I'm an office manager and do the coding along with all the other office management tasks. I'm thinking abou... [ Read More ]
AAPC member Rosa Yanez CPC CRC CGIC CGSC has been a medical coder for 15 years and has worked for Humana as a senior Medicare risk adjustment educator for more than two years. Risk adjustment educatio... [ Read More ]
Understanding the rules surrounding interrupted stays in IPFs and IRFs is as easy as 123. When an interrupted stay occurs in an inpatient psychiatric facility IPF or inpatient rehab facility IRF a com... [ Read More ]
Using the right workload system leads to employee success. In any healthcare workplace employee accountability and engagement are paramount to patient and provider satisfaction as well as monetary liv... [ Read More ]
Embrace DEI data in applied behavior analysis and improve patient care for all. In the realm of healthcare the field of applied behavior analysis ABA has long been committed to understanding and impro... [ Read More ]
Know the rules for compliance before engaging in telehealth services. One of the things we love most about the internet is its unregulated nature. We post and share whatever we want achieving unpreced... [ Read More ]