Health Information Management

Health Information Management Articles by Topic: APCs

‘Clarification’ muddies the waters on lab order signatures

  • Briefings on APCs, Issue 12, December 1, 2009

    If you thought you understood CMS’ policy when it comes to physician orders for clinical...

Master modifiers to ensure accurate reimbursement

  • Briefings on APCs, Issue 12, December 1, 2009

    Proper modifier use is a critical part of coding, billing, and reimbursement. Currently, coders can...

Examine codes for complex OB/GYN procedures

  • Briefings on APCs, Issue 12, December 1, 2009

    Understand how to sift through detailed OB/GYN operative notes to ensure accurate code assignment.

Eliminate missed charges, errors to reduce lost revenue

  • Briefings on APCs, Issue 12, December 1, 2009

    Operational inefficiencies, outdated technology, and silo thinking can all lead to lost revenue...

Briefings on APCs, December 2009

  • Briefings on APCs, Issue 12, December 1, 2009

    In this issue, we examine outpatient coding challenges that facilities are still facing. We unravel...

Q/A: May we bill an E/M code for a wound care first visit

  • APCs Weekly Monitor, Issue 44, November 6, 2009

    Q.  Several of our facilities that include hospital-based outpatient wound care clinics have...

Tip: Determine the number of specimens to code surgical pathology correctly

  • APCs Weekly Monitor, Issue 44, November 6, 2009

    If you perform a level IV surgical pathology (88305) on more than one specimen from the same...

Modifier -59: Reduce risk, receive correct reimbursement

  • APC Payment Insider, Issue 11, November 1, 2009

    Learn how to correctly use modifier -59 and when to avoid it.

Two years later, medically unlike edits still a puzzle

  • APC Payment Insider, Issue 11, November 1, 2009

    Given the continuing confusion, what can facilities do to handle MUEs?

APC Payment Insider, November 2009

  • APC Payment Insider, Issue 11, November 1, 2009

    In this issue we unravel the mysteries surrounding medically unlikely edits. Inside: &bull...

Q&A: Determining the proper use of modifier -59

  • Briefings on APCs, Issue 11, November 1, 2009

    Our experts answer questions about the appropriate use of modifier -59.

I/OCE quarterly update: CMS addresses condition code 44, billing for radiopharmaceuticals and nuclear medicine

  • Briefings on APCs, Issue 11, November 1, 2009

    Condition code 44, billing for radiopharmaceuticals highlight I/OCE changes

Bill and charge for supplies correctly to reduce risk and lost revenue

  • Briefings on APCs, Issue 11, November 1, 2009

    Make sure you are coding and billing supplies correctly to decrease revenue loss.

Hospital outpatient departments need to know who is supervising

  • Briefings on APCs, Issue 11, November 1, 2009

    The second part of our two-part series on supervision requirements for diagnostic services.

Briefings on APCs, November 2009

  • Briefings on APCs, Issue 11, November 1, 2009

    This issue features the second part of our series on physician supervision requirements for...

Tip: Develop protocols for enforcing direct supervision requirements

  • APCs Weekly Monitor, Issue 43, October 30, 2009

    All diagnostic tests require some level of physician supervision. Staff members need to know the...

Q/A: Calcium gluconate administration: Infusion or hydration?

  • APCs Weekly Monitor, Issue 43, October 30, 2009

    Q. A patient who has undergone a kidney transplant and has plasmapheresis intravenously receives IV...

Q/A: Proper coding for multiple wounds at different sites

  • APCs Weekly Monitor, Issue 42, October 23, 2009

    Q: A patient with multiple wounds at different sites receives active wound management at one wound...

Tip: Distinguish between therapeutic and diagnostic tests

  • APCs Weekly Monitor, Issue 42, October 23, 2009

    Facilities need to have a clear understanding of when a procedure is diagnostic and when it is...

Tip: Appropriately report units in excess of MUE

  • APCs Weekly Monitor, Issue 41, October 16, 2009

    In FAQ 8736, CMS instructs hospitals how to report units in excess of the medically unlikely edits...

Q/A: Infusions in multilumen catheters

  • APCs Weekly Monitor, Issue 39, October 2, 2009

    Q: How should we assign CPT codes for an infusion of desferal at the same time as blood products...

Tip: Meet physician supervision requirements for diagnostic services

  • APCs Weekly Monitor, Issue 39, October 2, 2009

    How can your facility ensure compliance with the physician supervision requirements for diagnostic...

Coding Q&A

  • APC Payment Insider, Issue 10, October 1, 2009

    Does CPT 36592 pertain to a pre-existing catheter (such as a PICC line) that is available for use...

Separately payable drugs: New calculation method proposed for 2010 doesn’t equal increased payment

  • APC Payment Insider, Issue 10, October 1, 2009

    CMS proposes new methodology to calculate drug APC payment rates.

CMS proposes more changes to physician supervision requirements

  • APC Payment Insider, Issue 10, October 1, 2009

    Proposed changes to outpatient supervision could be a huge boon.

Coders beware?Is that screening colonoscopy really a screening?

  • Briefings on APCs, Issue 10, October 1, 2009

    Coders must understand what constitutes a ‘screening’ colonoscopy.

Two years later, MUEs are still a puzzle

  • Briefings on APCs, Issue 10, October 1, 2009

    Given the continuing confusion, what can facilities do to handle MUEs?

Physician supervision requirements not limited to therapeutic services

  • Briefings on APCs, Issue 10, October 1, 2009

    The first part of our two-part series on supervision requirements for diagnostic services.

Briefings on APCs, October 2009

  • Briefings on APCs, Issue 10, October 1, 2009

    This issue features the first part of our series on physician supervision requirements for...

Q/A: Billing code 92960 in the ED

  • APCs Weekly Monitor, Issue 38, September 25, 2009

    Q: Is elective cardioversion code 92960 billable in the ED? For example, a patient presents in the...

Q/A: Billing for items used with DME

  • APCs Weekly Monitor, Issue 37, September 18, 2009

    Q: We understand that we cannot charge for the use of equipment, but can we charge for the soft...

Tip: Understand Q status indicators

  • APCs Weekly Monitor, Issue 37, September 18, 2009

    Under the 2009 OPPS final rule, bundling is now subdivided into status indicators Q1, Q2, and Q3.

Tip: Differentiate between packaged and bundled services

  • APCs Weekly Monitor, Issue 36, September 11, 2009

    To distinguish between bundled and packaged services, remember that bundling applies to coding and...

Q/A: Reporting code 96372 for one dose administered via two injections

  • APCs Weekly Monitor, Issue 35, September 5, 2009

    Q. A physician orders one dose of a medication to be administered intramuscularly (IM) or...

Tip: Know the general definiation of 'immediately available' for physician supervision

  • APCs Weekly Monitor, Issue 35, September 4, 2009

    In its 2010 OPPS proposed rule, CMS acknowledges never having specifically defined...

Briefings on APCs, September 2009

  • Briefings on APCs, Issue 9, September 1, 2009

    In this issue, you will find an overview of the 2010 OPPS proposed rule, plus articles expanding on...

OPPS 2010 proposed rule: Earliest release brings fewer substantial policy changes

  • Briefings on APCs, Issue 9, September 1, 2009

    The text portion of the 2010 OPPS proposed rule is shorter than previous years’ rules, and...

2010 OPPS proposed rule: CMS proposes more changes to physician supervision requirements

  • Briefings on APCs, Issue 9, September 1, 2009

    Proposed changes to outpatient supervision could be a huge boon.

Separately payable drugs: New calculation method proposed for 2010 doesn’t equal increased payment

  • Briefings on APCs, Issue 9, September 1, 2009

    CMS proposes new methodology to calculate drug APC payment rates.

CMS discusses Section 1011 updates, OPPS proposed rule during HODF

  • Briefings on APCs, Issue 9, September 1, 2009

    Several items of interest to OPPS hospitals from Open Door Forum call.

Concepts review: Sort out packaged versus bundled services

  • Briefings on APCs, Issue 9, September 1, 2009

    Q status indicators add to packaged vs. bundled confusion.

APC Answer Letter September 2009

  • APC Answer Letter, Issue 9, September 1, 2009

    Select proper codes, modifiers for cardiac catheterization, injections and infusions, stent...

APC Payment Insider September 2009

  • APC Payment Insider, Issue 9, September 1, 2009

    In this issue we look at how the new ICD-9-CM codes increase specificity. Inside: CMS...

New ICD-9-CM codes increase specificity

  • APC Payment Insider, Issue 9, September 1, 2009

    ICD-9 code changes increase specificity to provide more information.

CMS clarifies outpatient ?observation services?

  • APC Payment Insider, Issue 9, September 1, 2009

    CMS revised language to clarify outpatient observation services.

Don?t code stent if lesion not crossed

  • APC Payment Insider, Issue 9, September 1, 2009

    Physician can’t cross lesion to place noncoronary stent

Code intended procedure when not completed

  • APC Payment Insider, Issue 9, September 1, 2009

    What should you do if a physician can’t complete the procedure?

Lack of start, stop times affects code selection

  • APC Payment Insider, Issue 9, September 1, 2009

    What should you do if a physician can’t complete the procedure?

Setting, insurer dictate payment policy

  • APC Payment Insider, Issue 9, September 1, 2009

    Is charging a patient for a low level facility visit appropriate?

Report drug and administration codes

  • APC Payment Insider, Issue 9, September 1, 2009

    Make sure you include CPT and HCPCS codes for drugs

Report in facility setting only

  • APC Payment Insider, Issue 9, September 1, 2009

    Know when to report an IV push of the same substance in ER

Q/A: Is patient considered high risk after non-adenomatious polyp removal?

  • APCs Weekly Monitor, Issue 33, August 28, 2009

    Q: Is a patient who underwent a colonoscopy and polyp removal three years ago considered high risk...

Resubmit comments on OPPS proposed rule

  • APCs Weekly Monitor, Issue 33, August 28, 2009

    CMS requests that everyone who submitted comments on the 2010 proposed Physician Fee Schedule or...

Q/A: Coding for incomplete stent placement

  • APCs Weekly Monitor, Issue 32, August 21, 2009

    Q: How should we code the following scenario: A patient arrives at the catheterization laboratory...

Tip: Comment on the 2010 OPPS proposed rule

  • APCs Weekly Monitor, Issue 32, August 21, 2009

    What do you thinkof the 2010 OPPS proposed rule? You can submit comments to CMS until August 31.

Q/A: Limits on PET scans

  • APCs Weekly Monitor, Issue 31, August 13, 2009

    Q: Is there a limit on how frequently patients may receive PET scans, such as 78815 (Tumor...

Tip: Use these principles to develop E/M coding guidelines

  • APCs Weekly Monitor, Issue 31, August 13, 2009

    No national guidelines for E/M leveling exist, so facilities must develop their own.

Q/A: Report modifier -59 for EKGs performed before or after cardiac catheterization

  • APCs Weekly Monitor, Issue 30, August 7, 2009

    Q. An APC edit states that 93005 (electrocardiogram, routine EKG with at least 12 leads; tracing...

Ensure medical necessity to curb outpatient revenue loss

  • Briefings on APCs, Issue 8, August 1, 2009

    Facilities are failing to meet medical necessity requirements

New ICD-9-CM codes increase specificity

  • Briefings on APCs, Issue 8, August 1, 2009

    ICD-9 code changes increase specificity to provide more information.

Briefings on APCs, August 2009

  • Briefings on APCs, Issue 8, August 1, 2009

    In this issue, you will find information about the new updates to the ICD-9 codes and look at how...

Set the bar with outpatient coding productivity standards

  • APC Payment Insider, Issue 8, August 1, 2009

    HIM departments need to establish coding productivity standards.

APC Payment Insider, August 2009

  • APC Payment Insider, Issue 8, August 1, 2009

    In this issue we look at six questions you should ask when you evaluate coder productivity...

Q/A: Physical and occupational therapy in the outpatient department

  • APCs Weekly Monitor, Issue 29, July 31, 2009

    Q: What are the guidelines for physician supervision for physical therapy/occupational therapy and...

Q/A: Facility guidelines for E/M levels

  • APCs Weekly Monitor, Issue 28, July 24, 2009

    Q: I work in a hospital outpatient clinic setting. Has CMS issued a deadline for developing...

Tip: Consider non-coding tasks when setting coder productivity goals

  • APCs Weekly Monitor, Issue 28, July 17, 2009

    When setting productivity goals, don’t forget to include non-coding responsibilities when...

CMS releases 2010 OPPS proposed rule

  • HIM Connection, Issue 28, July 14, 2009

    Outpatient facilities and pharmacies hoping to see an increase in reimbursement for separately...

Q/A: Coding for blood glucose checks

  • APCs Weekly Monitor, Issue 27, July 10, 2009

    Q: Which CPT code is appropriate for blood glucose monitoring with a device such as...

Q/A: Appropriate use of code 96376

  • APCs Weekly Monitor, Issue 26, July 3, 2009

    Q: My question pertains to CPT code 96376 (therapeutic, prophylactic, or diagnostic injection...

OSA: Put coverage problems to sleep with detailed documentation

  • APC Payment Insider, Issue 7, July 1, 2009

    CMS’ decision to broaden coverage of sleep testing for OSA is good news for facilities if...

APC Payment Insider, July 2009

  • APC Payment Insider, Issue 7, July 1, 2009

    In this issue we look at CMS’ recent decision to expand coverage of testing for obstructive...

Carefully review CMS’ national coverage analysis on PET scans

  • Briefings on APCs, Issue 7, July 1, 2009

    For years, it has been a challenge for healthcare facilities to determine whether Medicare will...

Inpatient ancillary services: Are your costs covered?

  • Briefings on APCs, Issue 7, July 1, 2009

    As the current economic climate continues to constrict cash flow for consumers and payers alike...

Briefings on APCs, July 2009

  • Briefings on APCs, Issue 7, July 1, 2009

    In this issue, you will find information about how your facility can increase its revenue by...

Q/A: Hydration services continuing past midnight

  • APCs Weekly Monitor, Issue 25, June 26, 2009

    Q: How should we report hydration services that run past midnight into the next calendar day along...

Tip: Don't forget to monitor coding productivity standards

  • APCs Weekly Monitor, Issue 25, June 26, 2009

    Establishing coding productivity standards is a necessary and challenging aspect of managing an...

Q/A: Critical care coding

  • APCs Weekly Monitor, Issue 24, June 19, 2009

    Q: My question pertains to critical care provided in an ER at a Level 1 Trauma Center. If a patient...

Set the bar with outpatient coding productivity standards

  • Briefings on APCs, Issue 7, June 12, 2009

    Editor’s note: The results of the survey discussed in this article are based on responses...

CMS releases April I/OCE update

  • Briefings on APCs, Issue 6, June 1, 2009

    CMS released its April 2009 quarterly update to the integrated outpatient code editor on March 13.

Strong documentation puts OSA coverage trouble to sleep

  • Briefings on APCs, Issue 6, June 1, 2009

    CMS’ decision to broaden coverage of sleep testing for OSA is good news for facilities if...

Go electronic to improve compliant charge capture

  • Briefings on APCs, Issue 6, June 1, 2009

    With increased ED volume and the demands of more complete documentation, now is the time to...

Briefings on APCs, June 2009

  • Briefings on APCs, Issue 6, June 1, 2009

    Inside: Go electronic to improve compliant charge capture Strong documentation puts OSA coverage...

Conform to the new CMS physician supervision requirements

  • APC Payment Insider, Issue 6, June 1, 2009

    CMS discussion of direct supervision requirements likely to spark more questions.

APC Payment Insider, June 2009

  • APC Payment Insider, Issue 6, June 1, 2009

    In this issue, we cover CMS’ updated clarifications regarding incident-to services and looks...

Q/A: Physician supervision requirements for outpatient facility

  • APCs Weekly Monitor, Issue 21, May 29, 2009

    Q: The nurse practitioner (NP) and physician assistant (PA) staff the off-campus clinic with...

Tip: Understand Q status indicator subcategories

  • APCs Weekly Monitor, Issue 20, May 22, 2009

    The 2009 OPPS final rule further divided the Q status indicator into three subcategories, with...

Q/A: Global payment structure and scheduled ED visits

  • APCs Weekly Monitor, Issue 19, May 15, 2009

    Q: A patient is seen in the ED for laceration repair and then returns for suture or staple removal...

Q&A: Assigning IV injection codes without stop times

  • Briefings on APCs, Issue 5, May 1, 2009

    Q. Is it appropriate to assign an IV injection code when facility nursing documentation does not...

Conform to the new CMS physician supervision requirements

  • Briefings on APCs, Issue 5, May 1, 2009

    Hospitals looking for more discussion about CMS? recent clarification of the direct supervision...

Review these important CY 2009 OPPS status indicator changes

  • Briefings on APCs, Issue 5, May 1, 2009

    In 2008, CMS greatly expanded the number of packaged items and services payable under the OPPS...

Solve the twin problems of ED revenue loss and compliance risk

  • Briefings on APCs, Issue 5, May 1, 2009

    As always, E/M levels must reflect resources consumed, and you still must have written policies and...

Briefings on APCs, May 2009

  • Briefings on APCs, Issue 5, May 1, 2009

    Inside: Solve the twin problems of ED revenue loss and compliance risk Overcome critical care...

APC Answer Letter May 2009

  • APC Answer Letter, Issue 5, May 1, 2009

    Inside: Blood procedures: Code correctly when the only service is specimen collection via...

APC Payment Insider May 2009

  • APC Payment Insider, Issue 5, May 1, 2009

    Inside: Watch for changing physician supervision requirements: today’s oversight may be...

Watch for changing physician supervision requirements

  • APC Payment Insider, Issue 5, May 1, 2009

    Five successive pieces of CMS guidance in the past year have altered the landscape...

CMS reviews negative pressure wound therapy devices

  • APC Payment Insider, Issue 5, May 1, 2009

    CMS has partnered with the Agency for Healthcare Research and Quality (AHRQ) to commission a review...

Q/A: Billing for CPT Code 86022

  • APCs Weekly Monitor, Issue 18, May 1, 2009

    Normal 0 false false false...

Conform to the new CMS physician supervision requirements

  • APCs Weekly Monitor, Issue 18, May 1, 2009

    Normal 0 false false false...

APC Answer Letter, April 2009

  • APC Answer Letter, Issue 4, April 1, 2009

    Inside: Charging for multiple ventricular leads Quick coding quiz

Understand when to append modifier -58

  • Briefings on APCs, Issue 4, April 1, 2009

    It's often difficult for coders and providers to determine when it's appropriate to append modifier...

Coders may not miss modifier -21

  • Briefings on APCs, Issue 4, April 1, 2009

    The departure of modifier -21 (prolonged E/M services), effective with the 2009 CPT Manual, isn't...

CMS reviews Negative Pressure Wound Therapy (NPWT) devices

  • Briefings on APCs, Issue 4, April 1, 2009

    CMS has partnered with the Agency for Healthcare Research and Quality (AHRQ) to commission a review...

Watch for changing physician supervision requirements

  • Briefings on APCs, Issue 4, April 1, 2009

    Five successive pieces of CMS guidance in the past year have altered the landscape. They are...

Clear up confusion regarding coding and billing for hospital supplies: Learn DME types and terminology

  • APC Payment Insider, Issue 4, April 1, 2009

    Coding and billing for hospital supplies can be confusing because of the complicated terminology...

APC Payment Insider April 2009

  • APC Payment Insider, Issue 4, April 1, 2009

    Inside: Control charge compression by knowing your costs, because consumer reaction may cost you...

Control charge compression by knowing your costs

  • APC Payment Insider, Issue 4, April 1, 2009

    Charge compression is a complex, long-standing problem. And although CMS is only now recognizing...

Trauma activation code

  • APC Payment Insider, Issue 4, April 1, 2009

    Assuming you meet all other documentation and trauma status criteria, you may report the trauma...

CPT checkup: Review the major changes for 2009

  • APC Payment Insider, Issue 3, March 27, 2009

    This is the second of two articles on this year?s CPT changes, effective January 1. Part two covers...

APC Answer Letter, March 2009

  • APC Answer Letter, Issue 3, March 1, 2009

    Inside: DME licenses Giving supplies away? Here’s how to become a supplier Nonchemotherapy...

APC Payment Insider, March 2009

  • APC Payment Insider, Issue 3, March 1, 2009

    Inside: CMS opens the door to outpatient HAC program CPT checkup: Review the major changes for...

CMS opens the door to outpatient HAC program

  • APC Payment Insider, Issue 3, March 1, 2009

    At a December 18, 2008, listening session, CMS presenters discussed possibilities for extending the...

500-plus CPT changes in 2009

  • APCs Weekly Monitor, Issue 1, January 2, 2009

    CPT coders face a lengthy list of changes for 2009. According to the American Academy of...

CMS releases 2009 OPPS final rule; trends continue

  • Briefings on APCs, Issue 1, January 1, 2009

    New composite APCs, continued emphasis on efficiency, and revised definitions for new and...

APC Answer Letter, January 2009

  • APC Answer Letter, Issue 1, January 1, 2009

    Inside: Blood draw via hep lock Cardiac catheterization: LIMA visualization Fluoroscopy for...

Facility critical care claims

  • APCs Weekly Monitor, Issue 52, December 26, 2008

     How to submit facility critical care claims for 2009

B&O suppositories

  • APCs Weekly Monitor, Issue 48, November 21, 2008

    In general, consider a belladona and opium (B&O) suppository as a self-administered drug, and...

Modifier -59 for certain EKGs

  • APCs Weekly Monitor, Issue 47, November 14, 2008

    You may report EKGs performed before or after cardiac catheterization with modifier -59. You cannot...

Proposed payment changes to Type B EDs

  • Briefings on APCs, Issue 11, November 1, 2008

    CMS has proposed to create four new APCs for Type B ED visits in the 2009 OPPS proposed rule, based...

Decipher integumentary codes for correct coding

  • Briefings on APCs, Issue 11, November 1, 2008

    Differentiate transfers, flaps, and grafting procedures, and make use of new codes and any trick to...

Make determinations for self-administered drugs

  • Briefings on APCs, Issue 11, November 1, 2008

    This is the first article in a two-part series. It provides the legal background of...

Opinions on payment changes to type B EDs vary

  • APCs Weekly Monitor, Issue 44, October 31, 2008

    Opinions on proposed payment changes to type B EDs vary

Reminder: Medicare covers diabetes screening

  • Briefings on APCs, Issue 10, October 1, 2008

    On June 18, CMS issued MLN Matters article SE0821, a reminder that Medicare pays for diabetes...

Questions on E/M for hospital-based outpatient clinics

  • Briefings on APCs, Issue 10, October 1, 2008

    Editor’s note: Susan Garrison, CHCA, PCS, FCS, CPC, CPC-H, CCS-P, CHC, CPAR, executive vice...

Meet planned APC payment reductions: eliminate unnecessary imaging services

  • Briefings on APCs, Issue 10, October 1, 2008

    Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS says without changing the way that...

Briefings on APCs, September 2008

  • Briefings on APCs, Issue 9, September 1, 2008

    Inside: CMS proposes five new composite APCs, reduces drug reimbursement; Avoid encoder traps...

Q&A: Report appropriate device codes for device-dependent procedures

  • APCs Weekly Monitor, Issue 20, May 16, 2008

    We are negotiating to provide pain stimulator services. We will report code 63650 for the trial and...