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Do you really think the constant CMS OPPS changes will end?
Unless you are planning to retire soon, you won't escape OPPS changes.
But you can influence them. You can be a part of shaping what CMS does by sharing your opinion in a roundtable forum.
THIS IS YOUR LAST CHANCE TO JOIN OTHERS AT THIS ROUNDTABLE AND BE HEARD BY CMS.
Join the Provider Roundtable sponsored by HCPro Inc., Nimitt Consulting Inc., and 3M Health Information and be one of 15 people representing different hospital departments who participate in this very important opportunity to be heard.
You can make a difference - but act today!
You know from experience what's needed to improve OPPS and APCs. Take three minutes today and apply. The comments of this group, if adopted by CMS, could save you and your peers time, money and energy.
Apply right now! E-mail Jugna Shah and
request an application. Deadline for submitting applications is only days away —May 15,
2003.
TODAY'S TOPICS: Coding multiple nebulizer
treatments provided the same day
Question: For CPT code 94664, "Demonstration and/or evaluation of patient
utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB
device," the instructions state that it can be reported only one time per day
of service.
If this is the case, how should we code multiple nebulizer
treatments per day? Some patients require more than one treatment per day.
Does this mean we can only charge one treatment?
Answer:
Nebulizer treatments should be reported using 94640. This code may be
reported multiple times per day to represent each medically necessary
nebulizer treatment that is ordered and performed on the patient.
Do not
charge 94664 at the same encounter as 94640 since the evaluation of the
patient is a component of 94640. Use modifiers -76 or -77 for each additional
treatment billed.
ASK
THE EXPERT: A patient is brought via ambulance to the ED on April 12 at 7 a.m. with a diagnosis of chest pain, 786.50. Cardiac enzymes, chest x-ray, and an EKG are ordered, and after evaluation, the ED physician orders a consultation from an attending doctor who orders observation on the same date of service, April 12 at 11 a.m.
The following day, April 13 at 7 a.m., a cardiologist is called for a consultation and determines that the patient needs a left cardiac catheterization, which is scheduled for 10 a.m. The cardiologist also orders additional diagnostic tests including cardiac enzymes, EKG, chest x-ray, etc. The left heart catheterization is negative. Patient is sent home in satisfactory condition the evening of April 13.
How will this encounter be reimbursed by Medicare?
Click here for the expert's answer!
PAY PER VIEW
Case study: Test your skills at coding aborted and completed procedures
Lolita M. Jones, RHIA, CCS, of Lolita Jones Consulting in Fort Washington, MD, presents you with an actual case study to practice your CPT and modifier coding skills.
To take the quiz, click here. The cost is $10. Briefings on APCs subscribers have free access via their online subscriptions.
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
EXPANSION OF THE 3-DAY PAYMENT WINDOW
Join HCPro for the 90-minute live audioconference, "Medicare's 3-Day Payment Window: Are You Prepared if it Expands?" and ensure you have policies in place to make sure these outpatient and inpatient bills are combined when appropriate.
This program will be presented on Thursday, May 15th, 2003. To register, or learn more, Click here
or, call 800/650-6787 and mention source code EZ9284C.
Coding Lunch & Learn ED coding CDs available
It's time for another Coding Lunch & Learn session. Gather your colleagues for a brown bag lunch and listen to the easy-to-understand ED Coding-Facility Leveling program from HP3 and HCPro.
It focuses on the challenges of ED coding, looks at actual ED records, and offers practical solutions for accurate assignment of facility levels. Train every member of the staff and award everyone valuable continuing education credits while they "Lunch & Learn."
For more information, CLICK HERE or call our customer service department at 800/650-6787. Be sure to mention source code EZ0810A.
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