Health Information Management Articles by Topic: APCs
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Briefings on APCs, Issue 12, December 1, 2009
If you thought you understood CMS’ policy when it comes to physician orders for clinical...
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Briefings on APCs, Issue 12, December 1, 2009
Proper modifier use is a critical part of coding, billing, and reimbursement. Currently, coders can...
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Briefings on APCs, Issue 12, December 1, 2009
Understand how to sift through detailed OB/GYN operative notes to ensure accurate code assignment.
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Briefings on APCs, Issue 12, December 1, 2009
Operational inefficiencies, outdated technology, and silo thinking can all lead to lost revenue...
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Briefings on APCs, Issue 12, December 1, 2009
In this issue, we examine outpatient coding challenges that facilities are still facing. We unravel...
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APCs Weekly Monitor, Issue 44, November 6, 2009
Q. Several of our facilities that include hospital-based outpatient wound care clinics have...
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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...
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APC Payment Insider, Issue 11, November 1, 2009
Learn how to correctly use modifier -59 and when to avoid it.
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APC Payment Insider, Issue 11, November 1, 2009
Given the continuing confusion, what can facilities do to handle MUEs?
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APC Payment Insider, Issue 11, November 1, 2009
In this issue we unravel the mysteries surrounding medically unlikely edits.
Inside:
&bull...
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Briefings on APCs, Issue 11, November 1, 2009
Our experts answer questions about the appropriate use of modifier -59.
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Briefings on APCs, Issue 11, November 1, 2009
Condition code 44, billing for radiopharmaceuticals highlight I/OCE changes
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Briefings on APCs, Issue 11, November 1, 2009
Make sure you are coding and billing supplies correctly to decrease revenue loss.
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Briefings on APCs, Issue 11, November 1, 2009
The second part of our two-part series on supervision requirements for diagnostic services.
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Briefings on APCs, Issue 11, November 1, 2009
This issue features the second part of our series on physician supervision requirements for...
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APCs Weekly Monitor, Issue 43, October 30, 2009
All diagnostic tests require some level of physician supervision. Staff members need to know the...
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APCs Weekly Monitor, Issue 43, October 30, 2009
Q. A patient who has undergone a kidney transplant and has plasmapheresis intravenously receives IV...
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APCs Weekly Monitor, Issue 42, October 23, 2009
Q: A patient with multiple wounds at different sites receives active wound management at one wound...
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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...
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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...
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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...
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APCs Weekly Monitor, Issue 39, October 2, 2009
How can your facility ensure compliance with the physician supervision requirements for diagnostic...
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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...
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APC Payment Insider, Issue 10, October 1, 2009
CMS proposes new methodology to calculate drug APC payment rates.
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APC Payment Insider, Issue 10, October 1, 2009
Proposed changes to outpatient supervision could be a huge boon.
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Briefings on APCs, Issue 10, October 1, 2009
Coders must understand what constitutes a ‘screening’ colonoscopy.
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Briefings on APCs, Issue 10, October 1, 2009
Given the continuing confusion, what can facilities do to handle MUEs?
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Briefings on APCs, Issue 10, October 1, 2009
The first part of our two-part series on supervision requirements for diagnostic services.
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Briefings on APCs, Issue 10, October 1, 2009
This issue features the first part of our series on physician supervision requirements for...
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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...
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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...
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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.
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APCs Weekly Monitor, Issue 36, September 11, 2009
To distinguish between bundled and packaged services, remember that bundling applies to coding and...
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APCs Weekly Monitor, Issue 35, September 5, 2009
Q. A physician orders one dose of a medication to be administered intramuscularly (IM) or...
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APCs Weekly Monitor, Issue 35, September 4, 2009
In its 2010 OPPS proposed rule, CMS acknowledges never having specifically defined...
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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...
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Briefings on APCs, Issue 9, September 1, 2009
The text portion of the 2010 OPPS proposed rule is shorter than previous years’ rules, and...
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Briefings on APCs, Issue 9, September 1, 2009
Proposed changes to outpatient supervision could be a huge boon.
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Briefings on APCs, Issue 9, September 1, 2009
CMS proposes new methodology to calculate drug APC payment rates.
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Briefings on APCs, Issue 9, September 1, 2009
Several items of interest to OPPS hospitals from Open Door Forum call.
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Briefings on APCs, Issue 9, September 1, 2009
Q status indicators add to packaged vs. bundled confusion.
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APC Answer Letter, Issue 9, September 1, 2009
Select proper codes, modifiers for cardiac catheterization, injections and infusions, stent...
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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...
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APC Payment Insider, Issue 9, September 1, 2009
ICD-9 code changes increase specificity to provide more information.
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APC Payment Insider, Issue 9, September 1, 2009
CMS revised language to clarify outpatient observation services.
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APC Payment Insider, Issue 9, September 1, 2009
Physician can’t cross lesion to place noncoronary stent
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APC Payment Insider, Issue 9, September 1, 2009
What should you do if a physician can’t complete the procedure?
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APC Payment Insider, Issue 9, September 1, 2009
What should you do if a physician can’t complete the procedure?
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APC Payment Insider, Issue 9, September 1, 2009
Is charging a patient for a low level facility visit appropriate?
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APC Payment Insider, Issue 9, September 1, 2009
Make sure you include CPT and HCPCS codes for drugs
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APC Payment Insider, Issue 9, September 1, 2009
Know when to report an IV push of the same substance in ER
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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...
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APCs Weekly Monitor, Issue 33, August 28, 2009
CMS requests that everyone who submitted comments on the 2010 proposed Physician Fee Schedule or...
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APCs Weekly Monitor, Issue 32, August 21, 2009
Q: How should we code the following scenario: A patient arrives at the catheterization laboratory...
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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.
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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...
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APCs Weekly Monitor, Issue 31, August 13, 2009
No national guidelines for E/M leveling exist, so facilities must develop their own.
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APCs Weekly Monitor, Issue 30, August 7, 2009
Q. An APC edit states that 93005 (electrocardiogram, routine EKG with at least 12 leads; tracing...
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Briefings on APCs, Issue 8, August 1, 2009
Facilities are failing to meet medical necessity requirements
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Briefings on APCs, Issue 8, August 1, 2009
ICD-9 code changes increase specificity to provide more information.
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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...
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APC Payment Insider, Issue 8, August 1, 2009
HIM departments need to establish coding productivity standards.
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APC Payment Insider, Issue 8, August 1, 2009
In this issue we look at six questions you should ask when you evaluate coder productivity...
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APCs Weekly Monitor, Issue 29, July 31, 2009
Q: What are the guidelines for physician supervision for physical therapy/occupational therapy and...
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APCs Weekly Monitor, Issue 28, July 24, 2009
Q: I work in a hospital outpatient clinic setting. Has CMS issued a deadline for developing...
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APCs Weekly Monitor, Issue 28, July 17, 2009
When setting productivity goals, don’t forget to include non-coding responsibilities when...
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HIM Connection, Issue 28, July 14, 2009
Outpatient facilities and pharmacies hoping to see an increase in reimbursement for separately...
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APCs Weekly Monitor, Issue 27, July 10, 2009
Q: Which CPT code is appropriate for blood glucose monitoring with a device such as...
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APCs Weekly Monitor, Issue 26, July 3, 2009
Q: My question pertains to CPT code 96376 (therapeutic, prophylactic, or diagnostic injection...
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APC Payment Insider, Issue 7, July 1, 2009
CMS’ decision to broaden coverage of sleep testing for OSA is good news for facilities if...
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APC Payment Insider, Issue 7, July 1, 2009
In this issue we look at CMS’ recent decision to expand coverage of testing for obstructive...
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Briefings on APCs, Issue 7, July 1, 2009
For years, it has been a challenge for healthcare facilities to determine whether Medicare will...
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Briefings on APCs, Issue 7, July 1, 2009
As the current economic climate continues to constrict cash flow for consumers and payers alike...
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Briefings on APCs, Issue 7, July 1, 2009
In this issue, you will find information about how your facility can increase its revenue by...
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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...
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APCs Weekly Monitor, Issue 25, June 26, 2009
Establishing coding productivity standards is a necessary and challenging aspect of managing an...
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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...
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Briefings on APCs, Issue 7, June 12, 2009
Editor’s note: The results of the survey discussed in this article are based on responses...
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Briefings on APCs, Issue 6, June 1, 2009
CMS released its April 2009 quarterly update to the integrated outpatient code editor on March 13.
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Briefings on APCs, Issue 6, June 1, 2009
CMS’ decision to broaden coverage of sleep testing for OSA is good news for facilities if...
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Briefings on APCs, Issue 6, June 1, 2009
With increased ED volume and the demands of more complete documentation, now is the time to...
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Briefings on APCs, Issue 6, June 1, 2009
Inside:
Go electronic to improve compliant charge capture
Strong documentation puts OSA coverage...
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APC Payment Insider, Issue 6, June 1, 2009
CMS discussion of direct supervision requirements likely to spark more questions.
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APC Payment Insider, Issue 6, June 1, 2009
In this issue, we cover CMS’ updated clarifications regarding incident-to services and looks...
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APCs Weekly Monitor, Issue 21, May 29, 2009
Q: The nurse practitioner (NP) and physician assistant (PA) staff the off-campus clinic with...
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APCs Weekly Monitor, Issue 20, May 22, 2009
The 2009 OPPS final rule further divided the Q status indicator into three subcategories, with...
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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...
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Briefings on APCs, Issue 5, May 1, 2009
Q. Is it appropriate to assign an IV injection code when facility nursing documentation does not...
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Briefings on APCs, Issue 5, May 1, 2009
Hospitals looking for more discussion about CMS? recent clarification of the direct supervision...
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Briefings on APCs, Issue 5, May 1, 2009
In 2008, CMS greatly expanded the number of packaged items and services payable under the OPPS...
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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...
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Briefings on APCs, Issue 5, May 1, 2009
Inside:
Solve the twin problems of ED revenue loss and compliance risk
Overcome critical care...
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APC Answer Letter, Issue 5, May 1, 2009
Inside:
Blood procedures: Code correctly when the only service is specimen collection via...
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APC Payment Insider, Issue 5, May 1, 2009
Inside: Watch for changing physician supervision requirements: today’s oversight may be...
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APC Payment Insider, Issue 5, May 1, 2009
Five successive pieces of CMS guidance in the past year have altered the landscape...
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APC Payment Insider, Issue 5, May 1, 2009
CMS has partnered with the Agency for Healthcare Research and Quality (AHRQ) to commission a review...
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APCs Weekly Monitor, Issue 18, May 1, 2009
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APCs Weekly Monitor, Issue 18, May 1, 2009
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APC Answer Letter, Issue 4, April 1, 2009
Inside:
Charging for multiple ventricular leads
Quick coding quiz
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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...
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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...
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Briefings on APCs, Issue 4, April 1, 2009
CMS has partnered with the Agency for Healthcare Research and Quality (AHRQ) to commission a review...
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Briefings on APCs, Issue 4, April 1, 2009
Five successive pieces of CMS guidance in the past year have altered the landscape. They are...
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APC Payment Insider, Issue 4, April 1, 2009
Coding and billing for hospital supplies can be confusing because of the complicated terminology...
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APC Payment Insider, Issue 4, April 1, 2009
Inside: Control charge compression by knowing your costs, because consumer reaction may cost you...
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APC Payment Insider, Issue 4, April 1, 2009
Charge compression is a complex, long-standing problem. And although CMS is only now recognizing...
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APC Payment Insider, Issue 4, April 1, 2009
Assuming you meet all other documentation and trauma status criteria, you may report the trauma...
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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...
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APC Answer Letter, Issue 3, March 1, 2009
Inside:
DME licenses
Giving supplies away? Here’s how to become a supplier
Nonchemotherapy...
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APC Payment Insider, Issue 3, March 1, 2009
Inside: CMS opens the door to outpatient HAC program CPT checkup: Review the major changes for...
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APC Payment Insider, Issue 3, March 1, 2009
At a December 18, 2008, listening session, CMS presenters discussed possibilities for extending the...
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APCs Weekly Monitor, Issue 1, January 2, 2009
CPT coders face a lengthy list of changes for 2009. According to the American Academy of...
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Briefings on APCs, Issue 1, January 1, 2009
New composite APCs, continued emphasis on efficiency, and revised definitions for new and...
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APC Answer Letter, Issue 1, January 1, 2009
Inside:
Blood draw via hep lock
Cardiac catheterization: LIMA visualization
Fluoroscopy for...
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APCs Weekly Monitor, Issue 52, December 26, 2008
How to submit facility critical care claims for 2009
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APCs Weekly Monitor, Issue 48, November 21, 2008
In general, consider a belladona and opium (B&O) suppository as a self-administered drug, and...
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APCs Weekly Monitor, Issue 47, November 14, 2008
You may report EKGs performed before or after cardiac catheterization with modifier -59. You cannot...
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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...
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Briefings on APCs, Issue 11, November 1, 2008
Differentiate transfers, flaps, and grafting procedures, and make use of new codes and any trick to...
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Briefings on APCs, Issue 11, November 1, 2008
This is the first article in a two-part series. It provides the legal background of...
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APCs Weekly Monitor, Issue 44, October 31, 2008
Opinions on proposed payment changes to type B EDs vary
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Briefings on APCs, Issue 10, October 1, 2008
On June 18, CMS issued MLN Matters article SE0821, a reminder that Medicare pays for diabetes...
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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...
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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...
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Briefings on APCs, Issue 9, September 1, 2008
Inside: CMS proposes five new composite APCs, reduces drug reimbursement; Avoid encoder traps...
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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...