| Friday,
April 18, 2003
Vol. 4, No. 15 
SUBSCRIBE
Tubby Tumor
How much did the largest intact tumor ever removed weigh?
The answer will appear in next week's APC Weekly Monitor, or be one of
the first five to e-mail the correct answer and win a free "2003 Coding Coach Play Book"!
LAST WEEK'S ANSWER: Sleep
Death will occur about 10 days without sleep, starvation takes weeks.
Window Shopping Monitor-Style
We've got terrific resources for your APC coding team. Check out
our two APC newsletters.
"Briefings
on APCs" is a monthly newsletter devoted entirely to managing under
APCs, including tips, charts, and advice from the experts.
"APC
Answer Letter" is a question and answer publication - readers supply
the questions, our experts supply the answers. Click on the links to find
out more.
SPONSORS
IRP, Inc.
IRP's CODING SOFTWARE
Specifically designed for Medicare APC compliance, IRP's coding
software fits ALL platforms and is easily integrated with existing
applications. Visit our comprehensive APC Reference Library.
Click or call
800-634-0496 x244.
INFO-X
Medical Necessity Solutions
With Info-X you can integrate your local LMRPs and NCDs into your HIS.
Leverage existing system capabilities to provide ABN alert, print the ABN
and apply the appropriate occurrence codes.
Increased reimbursement, minimum cost, risk, infrastructure,
training/education & least time to implement.
For more information, click here or call 800-299-1091 ext. 34.
|
THE MONITOR'S ADVISORY BOARD
Keith Siddel,
MBA, PhD (c),
president, CEO
HRM, Hospital Resource Management
Cheryl D'Amato,
RHIT, CCS,
director health information
management
HSS, Inc.
Julie Downey,
CPC, CPC-H,
ambulatory coding coordinator,
HIM
University Colorado
Hospital
Carole Gammarino,
RHIT, CPUR,
Independent
Consultant
Julia R. Palmer
MBA, RHIA, CCS,
president
Health Information Management Division of
HRM
Valerie Rinkle, MPA,
revenue cycle director
Asante Health System
On Himinfo.com
TIP OF
THE WEEK
ASK
THE EXPERT
HIM
VENDOR BUSINESS DIRECTORY
|
Cardiac catheterization documentation tips
(Tired of struggling with CMS changes? Join the Provider Roundtable and speak out! See below)
For coders to assign cardiac catheterization codes accurately, medical record documentation provided to the coders must contain the answers to the following six questions, says Lolita Jones, RHIA, CCS, of Lolita M. Jones Consulting Services, Fort Washington, MD: -
Does the patient have a congenital cardiac anomaly?
- What side or sides of the heart was catheterized?
- If left heart catheterization, what method was used to access the left side of the heart?
- Was angiography performed? If yes, on which site or sites?
- Was selective visualization/opacification of bypass graft or grafts performed? If yes, on which site or sites?
- Which additional code or codes should be assigned to classify the imaging supervision, interpretation and report for the injection procedures(s) performed during the cardiac catheterization?
For more helpful tips on how to correctly code outpatient cardiology procedures, check out the audio tape of HCPro's recent audio conference featuring Lolita Jones and Pam Hess, RHIA, CPC, principal at the Wellington Group LLC, Cleveland, OH.
Your APCs Weekly Monitor, is a free weekly e-zine from HCPro,
publisher of Briefings on APCs, the monthly newsletter devoted
entirely to managing under APCs, and the newsletter, APC Answer
Letter, with answers to readers' questions about coding for APCs.
The Monitor is a complimentary companion publication, with a
specific mission: to provide answers to your tough questions about the APC
regulations.
If you have a question about APC coding that you would like addressed
in the Monitor, post it on our Web site at himinfo.com.
Each week, our team of experts answers questions that will appeal to
the majority of readers. The elected questions and their corresponding
answers are delivered to your inbox every Friday.
TODAY'S TOPICS: Who can do E/M level coding?
Question:
Does an RN have to be on the premises in order to charge an E/M level or can a physician with an LPN be permitted?
Answer:
If the service is medically necessary and provided by or under
the supervision of a licensed practitioner according to hospital bylaws, licensing, and accreditation requirements, you may bill for the service.
Keith Siddel, Cheryl D'Amato, Julie Downey, Jeannie Gourgeot, and Julia Palmer
contributed to this week's answer.
ASK
THE EXPERT: Is it appropriate to code a diagnosis from the anesthesiologist's history and physical if it doesn't conflict with the primary physician's diagnosis?
PAY PER VIEW:
Outpatient outlier review is inevitable
Outpatient billing department staffs probably heaved a sigh of relief earlier this year when CMS focused its outlier payment investigation on inpatient billing.
But they shouldn't get too comfortable given that the Office of the Inspector General (OIG) has already begun investigating hospitals under OPPS for outlier overpayments.
To read more, the cost is $10. Briefings on APCs subscribers have free access via their online subscriptions.
Coding and Compliance Feature Article of the Month:
Observation miscoding can cost you
Speak out to CMS
Do you have concerns about OPPS and APCs that you would like to share with
CMS?
Here is your chance!
Participate in the Provider Roundtable sponsored by HCPro Inc., Nimitt
Consulting Inc., and 3M Health Information. The roundtable panel will
consist of 15 health professionals representing different hospital
departments that deal with OPPS and APC changes every day.
Jugna Shah, MPH, of Nimitt Consulting Inc., the group's facilitator, will
work with members to document the groups' comments and questions
regarding the 2004 proposed rule, provide an opportunity for reviewing
the document, and then submit it on behalf of the group to CMS as part of its request for
comments process.
Join your health care professional peers in presenting a united voice to
CMS.
To apply,e-mail Jugna Shah and request an application.
Deadline
for submitting applications is May 15, 2003.
Questions from readers are answered by a team
of experts working in the APC area within the health care industry. Their
answers are provided as advice. Readers should consult the federal
regulations governing OPPS, related CMS sources, and with their local
fiscal intermediary before making any decisions regarding the application
of OPPS to their particular situations.
EDITOR'S CHOICE
New Coding Lunch and Learn 2003 CDs are here!
Gather your colleagues for a brown bag lunch and listen to the easy-to-understand CODING LUNCH AND LEARN 2003: THE 5W's OF INPATIENT DOCUMENTATION. Learn the "who," "what," "when," "why," and "where" keys to improve documentation. You'll even earn valuable continuing education credits while you Lunch and Learn.
For more information, CLICK HERE or call our Customer Service Team at 800-650-6787. Please mention source code EZ0727A when you call.
Why are breast procedure and mammography coding and documentation so important?
Are you aware of recent coding and modifier changes for breast procedure coding? It's critical that it is done accurately, in a timely manner, and in compliance with government standards to avoid false claims. It's important to the fiscal well-being of your facility and to ensure that patients receive appropriate results of their procedures.
Learn what you need to know during a 90-minute live audioconference, "Strategies for Accurate Breast Procedure and Mammography Coding" on Tuesday, April 29, beginning at 1 p.m. Eastern. You need a solid understanding to be in compliance.
For more information or to register, CLICK HERE
or call our customer service department at 800-650-6787. Be sure to mention source code EZ9087A.
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Most Popular
Related Articles
| 
