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APCs Weekly Monitor
This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations. Topics include the outpatient code editor (OCE), complex coding issues, beneficiary co-payment discounting, and cross-department APCs tracking.
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APCs Weekly Monitor
Issue 52, December 26, 2008
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Facility critical care claims
How to submit facility critical care claims for 2009 -
Revised Medicare policy on bariatric surgery
CMS announced a proposal to clarify its policies about Medicare coverage of bariatric surgery as a... -
2009 OPPS final rule released
New composite APCs, continued emphasis on efficiency, and revised definitions for new and... -
Trivia
Trivia for the holiday season
Issue 51, December 19, 2008
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Your pharmacy CDM
Summary of the OPPS 2009 updates for pharmacy -
Updates to Revenue Cycle white papers
The HCPro Revenue Cycle Institute announces that new and updated white papers are available for... -
Trivia
Winter weather trivia
Issue 50, December 12, 2008
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Facility E/M Levels, 2009 OPPS
For 2009, hospitals must continue to use their internally developed guidelines for ED and clinic... -
Opportunity knocks!
APCs Weekly Monitor is expanding its panel of contributors. If you’re a coding specialist and... -
Coding secondary diabetes
Coder understanding of the origin of secondary diabetes is important to help ensure coding... -
Trivia
Holiday season trivia
Issue 49, December 5, 2008
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Bill technical component for procedures
When patients present for a procedure that uses facility space, supplies and resources, facilities...
Issue 48, November 21, 2008
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B&O suppositories
In general, consider a belladona and opium (B&O) suppository as a self-administered drug, and... -
Coverage policy for bariatric surgery for diabetes
A CMS proposed decision in November, 2008 notes that type 2 diabetes is one of the co-morbidities... -
Controversial dates for ICD-10
Controversy arises over the implementation of the new HIPAA electronic transaction form 5010 on... -
Trivia
Trivia
Issue 47, November 14, 2008
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Modifier -59 for certain EKGs
You may report EKGs performed before or after cardiac catheterization with modifier -59. You cannot... -
2009 HCPCS level II released
CMS has delivered the annual scheduled release of modifications to the HCPCS II code set. Changes... -
Best practices for self-administered drugs
When developing best practices for implementing self-administered drug policies, always remember... -
Trivia
Trivia
Issue 46, November 7, 2008
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Charge CPT procedure codes to inpatients under certain conditions
Charge CPT procedure codes to inpatients under certain conditions -
CMS releases 2009 OPPS final rule
Tip: CMS releases 2009 OPPS final rule -
Differentiate integumentary procedures
In this second article of a two-part series. John F. Bishop, PA-C, CPC, MS, CWS, examines some of...
Issue 45, October 31, 2008
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Use revenue code plus CPT, without HCPCS, to bill albuterol or Duoneb via nebulizer
Use revenue code plus CPT, without HCPCS, to bill albuterol or Duoneb via nebulizer -
Tip: Address coder shortage with an apprentice program
Tip: Address coder shortage with an apprentice program -
Trivia
Trivia
Issue 44, October 31, 2008
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Opinions on payment changes to type B EDs vary
Opinions on proposed payment changes to type B EDs vary
Issue 43, October 24, 2008
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Outpatient registration
Normal 0 false false false MicrosoftInternetExplorer4... -
Offshoring may be risky
Offshoring may be a potentially risky cost saver for organizations, but the practice also puts... -
Legal underpinnings of self-administered drug regulation
Learn the legal underpinnings of self-administered drug regulation. To understand self-administered... -
Trivia
Trivia
Issue 42, October 17, 2008
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Q&A: Does physician documentation written in reports equate to an official order?
Q&A: Does physician documentation written in reports equate to an official order? -
Differing payer requirements for revenue codes
Tip: You can have differing payer requirements for revenue codes -
Decipher integumentary codes
Dispel the assumption that an integumentary code is the only solution. Decipher complex repairs and... -
Trivia
Trivia:
Issue 41, October 10, 2008
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Q&A: Observe the correct CMS transmittal for facility/technical critical care
Q&A: Observe the correct CMS transmittal for facility/technical critical care -
Tip: Medicare covers diabetes screening
Tip: Medicare covers diabetes screening -
Eliminate unnecessary imaging services to meet 2009 APC payment reductions
Eliminate unnecessary imaging services to meet planned APC payment reductions in 2009. Without... -
Trivia
Trivia
Issue 40, October 3, 2008
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Q&A: Bill blood administration the same way for inpatient and outpatient accounts
Q&A: Bill blood administration the same way for inpatient and outpatient accounts -
Medicare publishes most MUEs
On October 1, 2008, CMS announced that it is immediately publishing most of the edits used in its... -
Get ready now for ICD-10
On August 15, 2008, the U.S. Department of Health and Human Services released its proposed... -
Trivia
Trivia
Issue 39, September 26, 2008
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Q&A: Follow the infusion hierarchy when reporting drug administration
Q&A: Follow the infusion hierarchy, not chronological order of administration, when reporting... -
Tip: Minimize potential for HIPAA violations when responding to the media
Tip: Minimize potential for HIPAA violations when responding to the media -
Salary survey: More responsibilities, little to no extra pay
Salary survey results show more responsibilities, little to no extra pay for HIM directors. -
Trivia
Trivia
Issue 38, September 19, 2008
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Q&A: Don't use modifier -53 for hospital OPPS claims
Why we shouldn’t append modifier -53 to the procedure if the patient is in the room, we... -
Tip: Dos and don'ts for out-of-network billing for ambulatory surgery centers
Consider the following dos and don’ts from Joshua M. Kaye, Esq., and Jerry J. Sokol, Esq... -
Pay per view: Understand minimum necessary requirements for disclosing protected health information
To protect patient privacy, HIPAA requires that staff members have access to the minimum... -
Trivia of the week
What color are the "black boxes" on commercial aircraft? Think you know the answer?
Issue 37, September 12, 2008
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Use modifier -50 correctly when reporting bilateral radiology procedures
Question: A physician orders a bilateral radiological examination of the hand, minimum of three... -
Tip: CMS contractors holding Pap smear claims using Q0091 until January
On September 4, CMS stated that it is instructing contractors to hold all claims containing HCPCS... -
Pay per view: clean up your MPI before implementing an EHR
Correcting duplicate numbers should be an ongoing effort, but this task becomes increasingly... -
Trivia
In 2004, what important discovery happened on the island of Flores in Indonesia? Think you know the...
Issue 36, September 5, 2008
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Distinguish between revenue codes 637, 250 for SADs
Q: Is it inappropriate to bill all self-administered drug (SAD) charges as integral to a procedure... -
Tip: Use modifier -58 appropriately
Modifier -58 indicates a staged or related procedure or service that the same physician performs... -
Pay Per View: CMS proposes five new composite APCs, reduces drug reimbursement
CMS released the display copy of the OPPS proposed rule for fiscal year 2009 on July 3, some three... -
Trivia
Which two cities have the oldest stadiums in major league baseball? Think you know the...
Issue 35, August 29, 2008
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Q&A: IV push, continuous infusions
Q: How should I code the following: Leucovorin started at 12:15 p.m. and ended at 2:27... -
Tip of the week: Report CPT code 45331 for sigmoidoscopy with biopsy
Report CPT code 45331 when a physician performs a sigmoidoscopy with biopsy. This code is... -
Pay per view: Prefabricated splint codes: No easy answers
When you ask any four coders or clinicians how to handle splint coding, you’re going to get... -
Trivia
Which performer went on last to close out Woodstock? Think you know the answer?
Issue 34, August 22, 2008
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Q&A: Report diagnostic radiopharmaceutical HCPCS code with nuclear medicine procedure
QUESTION: We perform a therapeutic thyroid treatment (code 79005) with radiopharmaceutical Iodine... -
Tip of the week: Consider reporting a V58 code with ESA therapy
Billers at the University of Texas’ MD Anderson Cancer Center encountered difficulties with... -
Pay per view: Implement the new ESA transmittals in your hospital
In her presentation during HCPro?s April 10 audio conference, Angela Simmons, CPA, director of... -
Trivia
What hipster said in 1948, “We’re a beat generation”? Think you know the...
Issue 33, August 15, 2008
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Q&A: When billing injection/infusion procedures, document the procedures appropriately to avoid "incidental only" rejections
QUESTION: I have a question regarding the modifier -25 information that the APCs Weekly Monitor... -
Tip of the week: Wound dressing is a bundled procedure when assessment is part of therapy
According to most Medicare local coverage determinations for wound care or physical rehabilitation... -
Pay per view: CMS discusses MIPPA, incident-to services, and more
CMS hosted a Hospital Open Door Forum (ODF) call July 17. During the call, CMS addressed several... -
Trivia of the week
What major league baseball team was forced to endure a 20-day road trip in 1996? Think you know...
Issue 32, August 8, 2008
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Report an E/M level with a debridement code only if the facility provides significant and separately identifiable services from the debridement
QUESTION: I code for a wound care facility and I disagree with my colleagues on when to assign an... -
Tip of the week: Use 29999, unlisted arthroscopic procedure, for radiofrequency capsular ACL tightening
Report 29999 for radiofrequency capsular ACL tightening. In radiofrequency capsular shrinkage, the... -
Pay per view: Unravel the costly inpatient-only procedures puzzle: Tips to avoid denials
Tips to avoid denials Few CMS rules are as confusing as those for inpatient-only procedures... -
Trivia of the week
What ancient Roman holiday was held to exorcise vampire-like ghosts of the dead?
Issue 31, August 1, 2008
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Q&A: Follow CMS' coding guidelines when using modifier -25
QUESTION: Are there any guidelines with respect to the appropriate use of modifier -25 for hospital... -
Tip of the week: Unravel the costly inpatient-only procedures puzzle with these prevention practices
Best prevention practices for outpatient facilities dealing with inpatient-only procedures and... -
Pay per view: Outpatient coders not exempt from the FY 2009 ICD-9 code changes
More revisions may come by October The National Center for Health Statistics (NCHS) released its... -
Trivia of the week
During World War II, U.S. pilots began reporting odd balls of light or shiny metallic spheres that...
Issue 30, July 25, 2008
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Q&A: Look for device transitional pass-through payments
QUESTION: Our organization has various thoughts about what items we should report with HCPCS code... -
Tip of the week: Postop pain/nausea medication, antibiotics generally not separately billable
In 2006, CMS posted a Q&A document clarifying the appropriateness of billing separately for postop... -
Pay per view: Avoid encoder traps to ensure coding compliance
Run your software: don?t let it run you Encoders are quickly becoming some of the most valuable... -
Trivia of the week
According to legend, a unibrow, tattoos, and a long middle finger are all signs of what Halloween...
Issue 29, July 18, 2008
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Q&A: Report appropriate CPT code and append modifier -52 for nuclear medicine procedures cancelled for clinical reasons
QUESTION: I really enjoyed your Q&A, "When to bill for terminated procedures and wasted supplies in... -
Tip of the week: CMS releases 2009 OPPS and ASC proposed rule
Big changes for EDs, diagnostic services, and quality measures CMS released its... -
Tip of the week: Medicare change affects all consultation codes
As of January 1, under the OPPS final rule, CMS has assigned status indicator B to E/M codes... -
Pay per view: Q&A: Experts tackle billing for implantable devices
Q: Are catheters, guidewires, etc., used during a heart catheter procedure considered implants... -
Trivia of the week
Who?s been Saturday Night Live?s most frequent host? Think you know the answer?
Issue 28, July 11, 2008
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Q&A: Instructions for use of revenue codes 450 and 451 differ by payer
QUESTION: One of the managed care organizations in our state (who administers one of our Tenncare... -
Pay per view: Report modifier -JW for discarded amounts of single-use drugs and biologicals (CAP participants excluded)
Providers should report modifier -JW (?Drug or biological amount discarded/not administered to any... -
Trivia of the week
What classic horror movie features a serial killer in a William Shatner mask? Think you know the...
Issue 27, July 4, 2008
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Q&A: Report code C1776 for complete joint replacement device as well as individual device components
QUESTION: When a coder in our HIM department reports code 27446 (arthroplasty, knee, condyle and... -
Tip of the week: Use modifier -59 when using multiple sites for separately identifiable services
When administering a chemotherapeutic agent in which protocol requires the use of two separate IV... -
Pay per view: Implement the new ESA transmittals in your hospital
Train your coding and clinical staff for ESA billing changes Why was a national coverage... -
Trivia of the week
What candy bar was named after its inventor’s family horse? Think you know the answer? -
Trivia of the week
What U.S. President once reported seeing a UFO?
Issue 26, June 20, 2008
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Q&A: Postop pain/nausea medication, antibiotics generally not separately billable
Q: Is it appropriate to bill for postop pain/nausea medications and... -
Tip of the week: Diagnostic and therapeutic services performed in the ED require a physician order
Medicare requires an order for therapeutic or diagnostic services performed in the ED. The Medicare... -
Tip of the week: Always report appropriate application code
Report a CPT code for the application of a splint regardless of whether the splint was... -
Pay per view: Outpatient documentation improvement
Sheila R. Gunn, CPC, CCS-P, PCS, CMBS-I, president of Medical Coding Consulting in Midlothian, VA... -
Pay per view: Coder vs. biller
Does this match have a referee? The subject can come up at any gathering of HIM professionals...
Issue 25, June 20, 2008
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Trivia of the week
What Depeche Mode song was inspired by Priscilla Presley’s book Elvis and Me?
Issue 24, June 13, 2008
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Q&A: Report HCPCS code P9612 for specimens obtained using a straight catheter
Q: Can we code bladder catheterizations when the urine specimen is obtained for an analysis and the... -
Tip of the week: Append modifier -59 correctly
There are many legitimate uses for modifier -59. But, with drug administration, as with other types... -
Don't be hasty when selecting an EHR vendor
A hasty EHR vendor selection can lead to frustration at best, or a failed implementation at worst... -
Trivia of the week
What type of pet did General Robert E. Lee keep with him during the Civil War?
Issue 23, June 6, 2008
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Q&A:Can your third-party payers process outpatient claims against NCCI edits?
QUESTION: Do the National Correct Coding Initiative (NCCI) unbundling prohibitions apply to payers... -
Tip: verify medical necessity and expect review of observation cases over 48 hours
Observation billing is addressed in the online Medicare Claims Processing Manual at Medicare Claims... -
Assess the financial effect of OPPS packaging
With the release of the 2008 OPPS final rule, CMS took drastic steps toward more aggressive... -
Trivia of the week
What famous tycoon bought the Desert Inn Hotel in Las Vegas after management attempted to evict him...
Issue 22, May 30, 2008
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Q&A: OIG considers "unbundling" fraudulent
Part 2 of a 2-part series. See the May 23, 2008 APCs Weekly Monitor for the CMS stance on... -
Tip: Don't report an E/M with every procedure; follow AMA guidelines for modifier -25
You should not charge or code an E/M every time you perform a wound care procedure. An OIG report... -
Tip: Ensure accurate coding of injections
Report code 90772 (therapeutic, prophylactic or diagnostic injection; subcutaneous of... -
Medically unlikely edits
Earlier this year, CMS advised that the medically unlikely edit (MUE) value for units with CPT... -
Trivia of the week
What color strip across the rear of a racecar signifies a rookie driver?
Issue 21, May 23, 2008
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Q&A: CMS considers "unbundling" fraudulent
Do CMS and the Office of Inspector General (OIG) consider the intentional unbundling of codes to be... -
Scheduled versus unscheduled ED care confusing
Questions from the March 18 HCPro audioconference, “Facility E/M Update: Meet CMS&rsquo... -
Trivia of the week
What famous artist was struck in the face with a mallet by an envious rival, disfiguring him for...
Issue 20, May 16, 2008
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Q&A: Report appropriate device codes for device-dependent procedures
We are negotiating to provide pain stimulator services. We will report code 63650 for the trial and... -
Tip: Use add-on codes for drugs administered at IV site
When charging for infusions that have multiple IV sites, treat each IV site separately. Report an... -
Tune your E/M documentation to the 2008 OPPS guidelines
The 2008 OPPS final rule challenges outpatient facilities to be more exact than ever regarding... -
Trivia of the week
Who is the only non-Jedi in the original Star Wars trilogy to use a lightsaber?
Issue 19, May 2, 2008
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Q&A: Rebill rejected claims containing HCPCS code A4641
We have had claims rejected for nuclear medicine procedures when we report both a procedure and a... -
Q&A: Understand guidelines for reporting self-administered drugs
How should we charge for self-administered drugs (SAD)? Should we charge for the drug itself and... -
Detailed physician documentation of wound care services ensures facility reimbursement
When a patient presents for a scheduled procedure, the hospital should report the CPT code that... -
Wound care coding and billing
Lingering coding and billing difficulties, 2008 CPT/HCPCS changes, and OIG scrutiny promise to keep... -
Trivia
What fast food restaurant is credited with introducing the first modern-day drive-thru window? -
Opportunity knocks! Will you answer?
Have you ever wanted to write about a subject you know extremely well? And have you ever wondered...
Issue 18, May 2, 2008
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Tip of the week: Don't make assumptions about duration for drug infusion therapy
It is not acceptable to make assumptions about duration of drug infusion therapy solely based on... -
RAC report casts spotlight on wrong patient settings
Hospitals nationwide are taking notice of the Recovery Audit Contractor (RAC) program and the 2007... -
Trivia of the week
Of the four main actors, who was the last living cast member of I Love Lucy?
Issue 17, April 25, 2008
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Report therapeutic, prophylactic, and diagnostic services as primary to hydration services
QUESTION: I have a question regarding the hierarchy of hydration, therapeutic infusions... -
Tip of the week: Although assessment is an integral part of all wound care services, do not report separately with E/M
Under the OPPS, when a patient presents for a scheduled procedure (e.g., wound care debridement... -
Pay per view: CMS releases an improved Advance Beneficiary Notice
In a much anticipated move, CMS released its new Advance Beneficiary Notice (ABN) of Noncoverage... -
Trivia of the week
Who established the first 365-day calendar?
Issue 16, April 18, 2008
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Q&A: Report separately payable drugs under revenue code 0636
QUESTION: Should we report all injectable drugs (i.e., J0000 -- J9999) under revenue code 0636... -
Tip of the week: Use caution when assigning HCPCS skin substitute codes
Be careful when assigning HCPCS skin substitute codes; the number of units should be equal to the... -
Pay per view: CMS discusses new Medically Unlikely Edits, inpatient versus observation status during recent ODF call
CMS hosted its most recent hospital Open Door Forum (ODF) call March 13 in which it addressed... -
Trivia of the week
What Indian tribe befriended the New England Pilgrims and helped them hunt, fish, and plant crops?
Issue 15, April 11, 2008
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Q&A: STVX and T-packaged codes
QUESTION: In Addendum B, CPT code 49465, Contrast injections(s) for radiological evaluation... -
Tip of the week: Concurrent hydration with separate access sites
If a separate venous access site is started for medically necessary hydration along with another... -
Pay per view: New information for ED trauma coding and charge capture creates confusion
New CMS guidance regarding services included in critical care CPT codes—codes that were... -
Trivia of the week
What was the first Arnold Schwarzenegger movie to win four Academy Awards?
Issue 14, April 4, 2008
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Bill all hours of observation when appropriate
QUESTION: Do you have any information on short stay observations that last anywhere from eight... -
Tip of the week: Coding and charging for orthotics and prosthetics
Orthotics and prosthetics can be billed by a facility with or without a durable medical equipment... -
Pay per view: Alleviate discharge disposition confusion to ensure compliance
Review special edition MLN Matters article, code descriptions Discharge dispositions--two-digit... -
Trivia of the week
What sitcom was among the top 20 most watched shows every season during its entire run, from 1984...
Issue 13, March 28, 2008
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Treating physicians must render supervision in provider-based departments
QUESTION: I read in the January 2008 OPPS manualization (Transmittal 82, published on February 8... -
Tip of the week: Bill the patient, not Medicare, for noncovered drugs
You should not bill noncovered drugs to Medicare. Although it is true that hospitals do not receive... -
Pay per view: Identify manifestations, probable underlying causes for altered mental status to capture patient severity
Dear colleagues: This month, we'll discuss documentation strategies for altered mental status... -
Trivia of the week
What four-word TV slogan did Sting add to the Dire Straits hit Money for Nothing?
Issue 12, March 21, 2008
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Charge appropriately for SQ/IM injections and IV push injections
QUESTION: We would like clarification regarding subcutaneous (SQ)/intramuscular (IM) injections... -
Tip of the week: Consider the following tip to help reduce unnecessary one-day lengths of stay (LOS)
Refer to your hospital's Program for Evaluating Payment Patterns Electronic Report, which will show... -
Pay Per View: Digest the new mandatory reporting requirements for ESA administration as of April 7
In January, CMS published three transmittals that present sizeable operational challenges when... -
Trivia of the week
Who was 11th-century Spanish military leader Rodrigo Diaz de Vivar better known as?
Issue 11, March 14, 2008
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Issue an ABN when observation care is not reasonable, necessary
QUESTION: Under the 2008 OPPS final rule, CMS packages observation services with evaluation and... -
Tip of the week: Be aware of CMS' additional criteria for E/M visits
Providers should understand that CMS has introduced an additional observation requirement for 2008... -
Pay Per View: Know critical care billing, documentation requirements
Physicians who take chances by skirting ethics to increase their revenue risk massive financial... -
Trivia of the week
What nation’s 90-man army is the world’s oldest, dating back to 1506?
Issue 10, February 29, 2008
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Do not report emergency E/M codes with critical care codes during same encounter
QUESTION: When is it appropriate to report emergency evaluation and management (E/M) codes... -
CMS to modify medically unlikely edit (MUE) for CPT code 90766 in April
QUESTION: Our fiscal intermediary (FI) has been returning claims that contain CPT code 90766 for IV... -
Tip of the week: Charge appropriately for radiopharmaceuticals
Before you decide how you'll set up your chargemaster at the start of each year, your facility... -
Pay Per View: Maintain compliance when coding from the medical record
You might think that everything between the first and last page of a medical record is fair game... -
Trivia of the week
What is the minimum number of musicians a band must have to be considered a "big band?"
Issue 9, February 29, 2008
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Report biopsy code only once when physician performs multiple biopsies
Regardless of how many biopsies a physician takes from a particular patient, report the appropriate... -
2008 Recovery audit contractor update: Review Statement of Work, start preparations now to maintain compliance
Although the recovery audit contractor (RAC) demonstration program is slated to end in March, that... -
Trivia of the Week
Combine Russian novelist Ivan Turgenev's "masterpiece of clashing generations" with D. H...
Issue 8, February 22, 2008
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Bill an E/M level in addition to debridement with proper documentation
QUESTION: A patient presents to a clinic for weekly wound care for multiple wound sites caused by... -
Tip of the Week: Do not append modifier -59 and -RT or -LT to the same procedure code
A Program Memo for fiscal intermediaries (FIs) from June 2000 (PMA-00-36) initially indicated... -
2008 OPPS final rule
The most significant change in the CMS packaging proposal from the proposed rule to the final rule... -
Trivia of the Week
The name Rachel is Hebrew for what type of animal?
Issue 7, February 15, 2008
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Report code 90765 for first hour, code 90766 for additional hours of IV infusion
QUESTION: We have a designated observation unit where we treat patients with IV infusion (i.e... -
Tip of the week: Follow CCI Guidelines for drug administration related to operative procedures
Under the integumentary section of the CCI Guidelines, Section J, "General Policy Statements," you... -
Pay-per-view: OIG Work Plan steps up focus on quality
Although the scope of work outlined in the Office of Inspector General (OIG) Work Plan for 2008 may... -
Trivia of the week
"But then I saw her face. Now I'm a believer. Not a trace of doubt in my mind." There is probably...
Issue 6, February 8, 2008
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Do not assign HCPCS code L8610 in the facility setting
QUESTION: We would like some clarification regarding when we can report HCPCS code L8610 (Ocular... -
Tip of the Week: Bill all drugs separately, regardless of Medicare's reimbursement
Hospitals should separately report all drugs regardless of whether Medicare will pay separately for... -
Pay-Per-View: Take a closer look at expanded packaging for 2008
One of the most significant changes to the OPPS since its August 2000 inception occurred in... -
Trivia of the Week
Pinto Colvig was the voice on the 1946 record album that introduced what character to children of...
Issue 5, February 1, 2008
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Report V codes under four primary circumstances
QUESTION: If a patient presents to a hospital outpatient infusion department for a Neulasta... -
Tip of the Week: Examine your facility's drug pricing
Hospitals should examine how they are pricing drugs and other services. Examine the drug cost and... -
Pay-Per-View: CMS publishes shocking critical care information
CMS hosted its most recent hospital Open Door Forum call December 20, 2007, and it contained... -
Trivia of the Week
Who played "Shoeless" Joe Jackson in the movie "Field of Dreams"?
Issue 4, January 25, 2008
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Understand status indicators for codes 36591 and 36592
QUESTION: We have a question regarding CPT codes 36591 and 36592 for collection of blood from an... -
Tip of the Week: Differentiate between STVX packaged and T-packaged services
It's important to understand that there are two types of services that have a status indicator of... -
Pay-Per-View: CMS discusses 2008 OPPS final rule and more
CMS hosted an Open Door Forum conference call for hospitals on November 8, 2007. During the call... -
Trivia of the Week
With whom did Dixie elope to Elk Green in the soap opera "All My Children"? -
Editor's note
Please note that there is additional information concerning the January 18 Tip of the Week.
Issue 3, January 18, 2008
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Determine the purpose and medical necessity of hydration before reporting it
QUESTION: When reporting a code for hydration, we know that documentation of medical necessity... -
Tip of the Week: Stay up-to-date on diagnostic radiopharmaceuticals in 2008
Although CMS packaged diagnostic radiopharmaceuticals for 2008, hospitals must submit HCPCS code(s... -
Pay-Per-View: Don’t skip a beat during electrophysiology exams
Electrophysiologists tailor EP studies to their patients and specific arrhythmias. In order to... -
Trivia of the Week
Who was the first African American physician to perform open heart surgery?
Issue 2, January 11, 2008
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Remember to bill one port film per week or once per five fractions with radiation oncology
QUESTION: Our business office has seen edits for radiation oncology claims that include port film... -
Tip of the Week: Choose AV ablation codes based on area of the heart, rhythm type
With an ablation, the electrophysiologist is trying to disrupt the electrical pathway that's... -
Pay-Per-View: 2008 OPPS final rule a radical change, sources say
The 2008 OPPS final rule marks the first occasion in which hospitals have seen a radical change to... -
Trivia of the Week
In Roman mythology, Janus is the god of what?
Issue 1, January 4, 2008
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Follow the new pricing information for the 2008 Laboratory Fee Schedule
QUESTION: Where can I find the 2008 Laboratory Fee Schedule? -
Tip of the Week: Follow Transmittal AB-03-114 to avoid denials
Consider the following scenario: A physician performs a screening colonoscopy and, because of poor... -
Pay-Per-View: CMS discusses POA reporting deadlines, inpatient orders
CMS hosted a Hospital Open Door Forum call on September 27, 2007 during which it discussed several... -
Trivia of the Week
How did poet/author Sylvia Plath pass away?
Issue 51, December 19, 2008
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Electronic health IT creates opportunities and challenges
Electronic health IT can increase the efficiency of recordkeeping and claims processing, but HIM...
Issue 49, December 5, 2008
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Tip: Put a stop to stamped signatures
Special edition MLN Matters article SE 0829 states clearly that hospitals cannot accept stamped... -
A sweet tool to monitor snooping staff
To catch snooping staff, some hospitals and other HIPAA-covered entities use fictitious medical... -
Trivia
Trivia
Issue 46, November 7, 2008
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Trivia
Trivia