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Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules and how they impact hospital health information management systems and processes, coding, billing, and reimbursement.

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Issue 12, December 21, 2002 - VIEW THE FULL ISSUE

• CMS issues final 2003 OPPS rule, increases payment rates

  “OPPS Advisor” is written by Jugna Shah, president of Nimitt Consulting Inc., in St...

• Help the radiologist and the coder speak the same language.

  Life would be a lot easier if the radiologist could code the procedure as well as perform it. But...

• Physician documentation drives observation payment.

  Write it right if you want to get paidAs hospitals get ready to expand observation services...

• Which modifiers do you need for these ED cases?.

  Lolita M. Jones, RHIA, CCS, of Lolita M. Jones Consulting in Fort Washington, MD, extends...

Issue 11, November 21, 2002 - VIEW THE FULL ISSUE

• A new year, a new way to look at claims data

  Multiple procedure claims roll into 2003 payment ratesWhen CMS rolls out the final 2003 OPPS rule...

• Clinical expertise helps coding make sense

  Should coders at your facility be clinically knowledgeable? The more clinical knowledge coders...

• It takes a village to raise a coder

  The most valuable asset in your APC toolkit may not be on your desktop. In fact, it’s...

• OIG 2003 Work Plan:

  “OPPS Advisor” is written by Jugna Shah, president of Nimitt Consulting in St. Paul...

Issue 10, October 21, 2002 - VIEW THE FULL ISSUE

• Assigning CPT codes accurately is the most challenging task facing HIM coders.

  Assigning CPT codes accurately is the most challenging task facing HIM coders.

• Uniform plan on the books for 2004

  Uniform plan on the books for 2004

• CMS launches national coverage determination for billing 23 lab tests

  New national reimbursement policies for some laboratory tests go into effect November 25 and...

• Jugna Shah, MPA,

  Jugna Shah, MPA,

• Quiz helps assess your practical understanding

  Quiz helps assess your practical understanding

Issue 9, September 21, 2002 - VIEW THE FULL ISSUE

• Coding Coach: Don’t leave conscious sedation money on the table

  Use of conscious sedation is be coming a standard practice for many diagnostic and surgical...

• OCE edits change coding requirements for knee procedure

  New CCI edits and Medicare policies are changing the way hospitals have to code knee surgery to...

• Proposal 2003 OPPS rule

  CMS issued the 2003 proposed OPPS rule August 6. The following are highlights: • Increased...

• Pulse oximetry: What’s all the fuss?

  For a service that results in no separate Medicare payment, pulse oximetry is getting a lot of...

• You can’t code it if you can’t read it

  Coder productivity is tied to reading, comprehension skillsThe biggest clue to whether coders...

Issue 8, August 21, 2002 - VIEW THE FULL ISSUE

• Clinicians not yet prepared to deal with observation APC

  APC Weekly Monitor readers weigh in via surveyMost of you are convinced your clinical staff do...

• Coding refresher: Test your knowledge on these operative reports

  Here’s a chance for you to test your coding and modifier knowledge, courtesy of Lolita M...

• Riding the big waves and struggling to stay afloat

  Jugna Shah, president of Nimitt Consulting Inc., in St. Paul, MN, writes “OPPS...

Issue 7, July 21, 2002 - VIEW THE FULL ISSUE

• Find the answers to your tough coding questions

  Sometimes it’s harder than it should beEditor’s note: This article was written by Joe...

• HIM directors debate who should do the coding

  Weigh your options for handling the observation APCAfter three months of coding the observation...

• Status indicators 101: Learn the ‘what and why’ on these one-letter

  As a coder, you juggle enough numbers and letters to create a new language, but there’s yet...

• The new observation APC requires some repeat tests for chest pain

  You’ll need to use modifiers if you want to get paidYou’ll have a better shot at full...

Issue 6, June 21, 2002 - VIEW THE FULL ISSUE

• OPPS Advisor: Big changes in store for passthrough drugs and devices

  A report from the field: Testifying before CMS on the 2003 rulesEditor’s Note: “OPPS...

• Code with an eye to ethical standards

  Document instructions that conflict with official guidelinesIn many cases, health plans and...

• Confusion solved: Modifier -GG replaces -GH on 2002 mammography claims

  You shouldn’t feel too bad if you’re confused trying to figure out whether to...

• Proof positive: Checking medical necessity saves big bucks

  If you need a reason to recommend a medical necessity verification program at your hospital, take...

• Coding Coach: Specific diagnosis coding is crucial to correct, timely payment

  Getting it right the first time is quicker than correcting an error.Always code to the highest...

• What’s new from CMS?

  CMS says ‘no’ to the OIGThe Department of Health and Human Services’ Office of...

Issue 5, May 21, 2002 - VIEW THE FULL ISSUE

• Coronary angiogram coding updated in 2002 rule

  Check your chargemasterLooking for lost revenue? Check the way you code CPT 93508 for a coronary...

• New CMS memos toss more changes into the 2002 rules

  You might think the March 1 Federal Register corrected all the errors in the November 30, 2001...

• One on one: Developing E/M point systems for outpatient coding

  Beth Hills, RHIA, CPC, coding and compliance manager at Great Valley Health, part of the Main Line...

Issue 4, April 21, 2002 - VIEW THE FULL ISSUE

• Chart your observation activities

  Now that CMS’ new observation APC for patients with asthma, congestive heart failure (CHF...

• Diagnostic testing: CMS clouds the coding rules

  A show of hands, please: How many think you should code based on the reason for requesting the...

• OIG Work Plan targets APCs

  Corrective action now will prevent future surprisesThe Office of Inspector General (OIG...

• OPPS Advisor: The 2002 rule: The good, the bad, and the ugly

  “OPPS Advisor” is written by Jugna Shah, president of Nimitt Consulting Inc., in St...

Issue 3, March 21, 2002 - VIEW THE FULL ISSUE

• An insider watches while CMS updates the APC process

  “OPPS Advisor” is written by Jugna Shah, president of Nimitt Consulting Inc., in St...

• Chargemaster Rx: An ailing hospital finds a fix

  Hundreds of thousands of dollars in lost revenue could be yours if you make updating your...

• Coding Corner: Huddle up: Coach calls for modifier -52 review

  “There is still some confusion as to when to use modifier -52, and it’s a good idea to...

• One new hire can help your facility save thousands in lost revenue

  Given the option, any hospital would choose to generate a bill and get paid rather than write...

• Searching for an ‘Education APC’

  Can your in-house patient education programs be billed to Medicare using APCs? The simple answer...

• The what and why of risk stratification

  While health care professionals across the country are cheering CMS’ decision to implement...

Issue 2, February 21, 2002 - VIEW THE FULL ISSUE

• CMS delays start of 2002 OPPS

  CMS delays start of 2002 OPPS

• CPT 2002 code book offers modifier challenges

  CPT 2002 code book offers modifier challenges

• Most coders are baffled by the new observation APC rules

  Most coders are baffled by the new observation APC rules

• Observation: See the light

  Observation: See the light

• Pass-throughs are here to stay, so you should review your CDM now

  Pass-throughs are here to stay, so you should review your CDM now

• What's new from CMS?

  What’s new from CMS?

Issue 1, January 21, 2002 - VIEW THE FULL ISSUE

• APC impact analysis: Are you getting paid the right amount?

  APC impact analysis: Are you getting paid the right amount?

• BAPC 2001 index

  BAPC 2001 index

• OPPS Advisor: CMS isn't ready for the 2002 OPPS changes, but you need to be

  OPPS Advisor: CMS isn’t ready for the 2002 OPPS changes, but you need to be

• Coding Coach: Modifier -52 should be used for reduced services with no anesthe

  Coding Coach: Modifier -52 should be used for reduced services with no anesthesia

• Set up your own modifier training program

  Set up your own modifier training program

• What's new from CMS?

  What’s new from CMS?