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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 1, 2007 - VIEW THE FULL ISSUE

• NDC reporting requirement creates burden for hospitals

  The use of the national drug code (NDC) to report medications is not a new concept for Medicaid...

• Go with the flow when coding EP exams

  Electrophysiology (EP) exams can resemble a sixth grader's Frankenstein science project: They...

• Q&A: Experts answer tough endoscopy coding scenarios

  Lolita M. Jones, RHIA, CCS, principal of Lolita M. Jones Consulting Services and vice president of...

Issue 11, November 1, 2007 - VIEW THE FULL ISSUE

• CMS announces proposed quality specifications

  CMS in August released data specifications for its 2009 proposed outpatient quality reporting...

• Educate or retrain your coding and clinical staff members on documentation needs to prevent ED revenue loss

  Medical professionals can identify with the concepts of meticulousness, consistency, and accuracy...

• Coding Q&A: Guidance to properly bill hospital supplies

  Editor's note: This article is the second in a two-part series. Following are answers to readers...

• Observation coding and billing scenarios demystified

  Establishing definitions for what constitutes observation time has been the cause of much confusion...

Issue 10, October 1, 2007 - VIEW THE FULL ISSUE

• New E/M guidance won't ruffle feathers

  According to CMS in the 2008 OPPS proposed rule, hospitals across the country have proved...

• CMS proposes shift toward extensive packaging

  On July 16, CMS released the 2008 OPPS proposed rule, which included a dramatic shift in the...

• Don't overlook the new ASC payment system

  Like many others in the healthcare industry, your hospital/outpatient facility may be bogged down...

• Don't let interventional radiology block your reimbursement

  The peripheral vascular system is one of the most complex areas of medicine to code and bill...

Issue 9, September 1, 2007 - VIEW THE FULL ISSUE

• Wholesale OPPS packaging

  On July 16, CMS released the 2008 OPPS proposed rule earlier than expected, and to the surprise of...

• CMS sheds light on proper modifier -59 use

  It seems like modifier -59 (distinct procedural service) is the black sheep of the coding industry...

• Steer clear of sinus surgery coding slipups

  Otolaryngologists, commonly known as ear, nose, and throat physicians (ENT), must complete a...

• Haste doesn't necessarily make waste

  Hospitals can be wasteful facilities by nature. Safety concerns often make these practices...

• CMS Hospital Open Door Forum update

  CMS hosted an Open Door Forum conference call for hospitals on July 17, during which it discussed...

Issue 8, August 1, 2007 - VIEW THE FULL ISSUE

• OIG releases startling debridement investigation

  In May, the OIG released its investigative findings on Medicare payments for surgical debridement...

• Stereotactic radiosurgery: Avoid common coding errors

  Editor's note: This article is the second in a two-part series. July's article covered...

• Develop templates to improve coding accuracy, productivity

  Documentation templates can accelerate the coding process and help fulfill the coder's mantra of...

• Keep an eye on OPPS updates, new Category III codes

  CMS issued a pair of important transmittals in June that update the OPPS and the OPPS OCE. The...

Issue 7, July 1, 2007 - VIEW THE FULL ISSUE

• UB-04 in effect: Is your staff using it properly?

  The new UB-04 billing form has replaced the veteran UB-92, and as of May 23 hospital billing/coding...

• Don't bill Medicare for physicianless ED visits, experts say

  A patient reports to a hospital's ED with a minor finger laceration. Nursing staff members triage...

• Hospital stereotactic radiosurgery: Get your claims paid

  Editor's note: This article is the first in a two-part series. Part two in the August Briefings on...

• Train your staff on drug administration charge capture

  Coding injections and infusions is a source of continued confusion for some nurses and coders. The...

• Coding Q&A: Experts tackle drug administration problems

  Editor's note: This article is the third in a three-part series. Following are answers to readers...

Issue 6, June 1, 2007 - VIEW THE FULL ISSUE

• RAC project goes national

  Hospitals that have paid little attention to the recovery audit contractors (RAC) demonstration...

• CMS discusses upgraded devices, EDs, and observation

  by Hugh E. Aaron, MHA, JD, CPC, CPC-H, senior vice president of compliance and regulatory...

• Prevent ED revenue loss with this auditing program

  Editor's note: This article is the second in a two-part series. Last month's article highlighted...

• Don't report IV infusion in addition to CT with contrast

  A patient reports to a hospital radiology department for a CT scan. The patient has documented...

• A new OPPS coming soon-keep an eye on operational/financial impact of TRICARE

  TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services, or...

• Coding Q&A: Experts tackle drug administration problems

  Editor's note: This article is the second in a three-part series. Following are answers to...

Issue 5, May 1, 2007 - VIEW THE FULL ISSUE

• Audit your ED to minimize potential revenue loss

  Target trouble spots with focused review Editor's note: This article is the first in a two-part...

• Speak clinical language and correct coding will follow

  For a coder to properly code a heart catheterization procedure note, he or she must first speak the...

• Help your hospital's compliance by using specialized IR staff

  Mary Washington Hospital in Fredricksburg, VA, has a busy catheter lab where physicians perform...

• Coding Q&A: Experts tackle drug administration problems

  Editor's note: This article is the first in a three-part series. Following are answers to readers...

Issue 4, April 1, 2007 - VIEW THE FULL ISSUE

• Ohio Valley case reinforces proper use of modifier -25

  Ohio Valley General Hospital (OVGH) in Pittsburgh "routinely billed the Medicare program for...

• Use these case studies to report appropriate E/M code

  To avoid falling into the same trap as Ohio Valley General Hospital in Pittsburgh, review the...

• Coding Q&A: Experts tackle splinting and orthopedics

  Editor's note: This article is the second in a two-part series Following are answers to readers...

• Do not report hydration concurrent with chemotherapy

  One particularly confusing aspect of the CPT drug administration rules is reporting services that...

Issue 3, March 1, 2007 - VIEW THE FULL ISSUE

• New ED G codes leave some questions unanswered

  Hospitals that have a "fast track" ED within their standard, 24-hour ED may experience operational...

• CMS to continue paying brachytherapy sources at charges reduced to cost

  For the past few years, CMS has paid for brachytherapy sources-radioactive seeds for treating...

• Use your 'SWOT' team to attack the top 10 changes in the 2007 OPPS Final Rule

  Editor's note: This article is the second in a two-part series. Last month's article examined...

• Coding Q&A: Experts answer readers' difficult questions

  Editor's note: This article is the first in a two-part series. Following are answers to a wide...

Issue 2, February 1, 2007 - VIEW THE FULL ISSUE

• Be wary of heavy revisions to radiology, cardiovascular sections of CPT Manual

  If you haven't already notified your radiology or cardiovascular departments of this year's CPT...

• Use your 'SWOT' team to attack the top 10 changes in the 2007 OPPS Final Rule

  Editor's note: This article is the first in a two-part series. Check back in March for the second...

• Are you ready to use the new trauma activation code?

  Effective January 1, you can report new HCPCS code G0390 (trauma response team activation...

• Chargemaster Q&A: Develop proper outpatient charges

  Locating official guidance on how to set appropriate CDM charges is often likened to finding a...

• New guidance on NPIs, trauma team activation, and more

  CMS hosted an Open Door Forum conference call for hospitals on December 14, 2006, and discussed...

Issue 1, January 1, 2007 - VIEW THE FULL ISSUE

• OPPS final rule contains a few surprises for providers

  Many proposals tweaked for final rule CMS showed a willingness to listen to providers and make...

• Revise your thinking: Overturn edits with 33223, 33222

  Use of modifier -59 warranted when physician documents 'pocket revision' When it comes to coding...

• 'Bundling' and 'packaging' are not synonymous terms

  Contrary to popular belief, "bundling" and "packaging" are not terms that coders should use...