Friday,
October 31, 2003
Vol. 6, No. 87
Visit Complianceinfo.com
SUBSCRIBE to Compliance Monitor
SUBSCRIBE to Health Care Auditing Weekly
Join the Compliance Monitor team!
SPONSORS
IRP, Inc.
IRP's Coding Software is specifically designed for Medicare DRG and APC compliance. Versions available for PCs and mainframes. Click here to use our APC Reference Library for the latest Medicare APC changes, or call 800/634-0496, x244.
ONE-STOP COMPLIANCE
Solve all of your biggest challenges-AUDITING, KICKBACKS, STARK, HIPAA,TRAINING, AND MEASURING EFFECTIVENESS with reporters who get the stories and ideas you need to comply and help your organization's bottom line!
"Strategies for Health Care Compliance," a 12-page monthly newsletter, helps you thrive in the ever-changing compliance environment by providing easy-to-understand compliance advice and analysis of the latest regulations. Each month, this newsletter offers how-to tips, features about your peers, policies and procedures, and tools for improving the efficiency and effectiveness of your corporate compliance programs. To learn more, click here or
call 800/650-6787.
|
On Complianceinfo.com
Sample compliance policies and procedures. (For subscribers to Strategies for Health Care Compliance only)
Sample audit programs. (For subscribers to Health Care Auditing Strategies only)
The OIG Work Plan for Fiscal Year 2003
Ask the Expert
Compliance Hot Topics: Billing and Coding, EMTALA, Stark, HIPAA
Question of the Week
|
Welcome to Compliance Monitor Q&A.
Our mission is to answer your difficult compliance questions-and your simple ones, too. To submit a question, send it to Compliance Monitor Q & A editor Kate Alvarez at kalvarez@hcpro.com.
We hope you enjoy this service and we welcome your feedback.
This week's questions
Pay-per-view article
Quick survey
Questions and Answers
Can codes for both CPR and the cardioversion be used for the same event?
Q:
When the patient comes in for atrial fib in the emergency room (ER), can electronic shock (cardioversion) be coded? We have a scenario in which the patient came into the ER, was cardioverted and within a short time went into crisis and CPR was started. Can codes for both CPR and the cardioversion be used?
A:
The CCI edits will rebundle the CPR with the cardioversion because usually, CPR is used until cardioversion can be performed. However, the scenario described above indicates that the CPR was provided in a "separate session" for an unrelated episode after the cardioversion was successful. You could append the modifier -59 to alert the carrier that this was the case. The carrier might request additional documentation, so make sure that the sequence of events is thoroughly documented.
In addition, it sounds as if you might want to review the use of the critical care codes as opposed to the ER codes to identify your evaluation and management services.
This question was answered by Susan Welsh, CPC. Welsh currently works with HCA as the Director of Coding and Education for the Physicians Services Ethics and Compliance Department.
Ever wonder how Susan Welsh started answering questions for Compliance Monitor Q&A? Well, you too can help your peers with their compliance issues! Just Click here or see the information below.
Back to top
WE NEED YOUR EXPERTISE!
Join the Compliance Monitor Team! Compliance Monitor Q&A relies upon experts just like you to answer pressing compliance questions. We're looking for experts in coding, billing, documentation, HIPAA, EMTALA, Stark, laboratories, and many other areas of compliance.
If you are interested in answering questions from your peers, please e-mail Compliance Monitor editor Kate Alvarez.
Take two!
Hours that is, and join us for the audioconference that will get you ready to face 2004 with confidence. We're changing our usual format for "APC Task Force: How to Implement the 2004 Final OPPS Rule" and running it as a two-hour program. There is so much important information to share, and you'll probably have questions. We want to help you to start the new year off right!
We'll look for you on Tuesday, December 9 beginning at 1 p.m. Eastern. Bring your lunch, a pad of paper, the materials package we'll send, along with your questions.
To register or to learn more, CLICK HERE or call our Customer Service Team at 800-650-6787. Please mention source code EZ23521B when you call.
Back to top
Tell us about your financial policies.
Click here to take our quick survey on your financial policies and procedures.
Back to top
Pay-Per-View article:
Follow the twists and turns of hernias to the right code
The word "hernia" usually makes you think of an external bulge, either at the umbilicus or in the groin. In fact, there are many different types of hernias, varying in origin and location.
The most common are the inguinal hernias, which can be congenital or acquired, direct or indirect, resulting in reducible or irreducible variances. When an inguinal hernia is irreducible, that only means that the contents of the bulge through the body wall cannot be manually placed back into the abdominal cavity. It does not imply that it is obstructed.
To find out more on how to properly code hernias, order the pay-per-view article "Follow the twists and turns of hernias to the right code." The cost is $10. Subscribers to the online version of Briefings on Coding Compliance Strategies have free access to this article. Subscribers to the print edition can find it in their October issues.
A $30 steal.
You can read this article and much more in the October issue of Briefings on Coding Compliance Strategies. Your cost: Five stories for only $30. You'll also learn how there may be partners for improved documentation right on your units, how your outpatient coders could be utilized for inpatient coding, the answers to four questions for better coding compliance, and how to sharpen your registration process for better reimbursement .
Back to top
Don't take discharge planning compliance lightly
Discharging patients isn't as simple as sending them out the door. There are regulatory and legal risks involved. Join us for an live 90-minute audioconference and get tips for reducing delay days and better managing length of stay; how to manage the ever challenging 'patient choice' issue; communicating with the chief financial officer and compliance officer, and learn how to improve the discharge process, from assessment to documentation.
We're saving a seat for you at "Discharge Planning Compliance: Strategies to Overcome Regulatory and Legal Risks" on Monday, November 24 beginning at 1 p.m. Eastern.
To register or to learn more, CLICK HERE or call our Customer Service Team at 800-650-6787. Please mention source code EZ23261B when you call.
Back to top
Outpatient setting: Is consistently charging the group code a requirement?
Q:
In an outpatient setting are we required to charge the group code consistently whenever two or more patients are seen together? Most of our managed care contracts do not specify whether therapy services are performed one-to-one or with another patient.
A: To read the answer to this question, click here.
Editor's note: Compliance Monitor Q&A has received several inquiries regarding the October 24th issue. We are currently researching the reference made to Medicare regulations on doctor's orders for outpatient diagnostic tests. Our team will inform you as soon as more information becomes available.
Back to top
Quick survey:
Does your organization train employees on Medicaid compliance issues?
To submit your answer, go to the Question of the Week at
Complianceinfo.com.
Here are the answers to the last survey:
When will your organization begin auditing its HIPAA compliance program?
- Within the next six months: 68%
- In 7 to 12 months: 17%
- In 12+ months: 9%
- We do not plan to audit: 6%
Back to top
Network with your audit colleagues
"Audit Talk" is a new, moderated chat forum that members can use to post messages or questions for their peers 24-hours-a-day. "Audit Talk" offers a free forum to network, share ideas, and solve problems for those in the audit industry. Getting involved is easy. To subscribe, just send your request to this e-mail: owner-audit_talk@hcpro.com.
Back to top
Share the news
You've been benefiting from our informative
e-mail newsletter, so why not pass on this resource to your peers? Sign up a colleague and get $20 off your next purchase on HCPro's Healthcare Marketplace!
Back to top
Send your comments and questions about Compliance Monitor Q&A to:
Kate Alvarez
Editorial Assistant
kalvarez@hcpro.com
|
