CMS is proposing significant changes to certain appeal processes for Medicare beneficiaries. In this Q&A, Kimberly A. Hoy, JD, CPC, director of Medicare and compliance for HCPro LLC, in Chicago, explains how the rule could affect hospitals, including new required notices and potential...Read More »
Q: How do you bill operating room (OR), anesthesia, and recovery time for cosmetic and medically necessary procedures performed during the same encounter?Read More »
Q: Are we allowed to bill the facility evaluation and management (E/M) service if a patient was triaged then left without being seen (LWBS) by a physician/nonphysician practitioner?Read More »
Q: If a patient in the emergency department (ED) leaves without being seen (LWBS) by a physician/nonphysician practitioner, should we have facility charges?Read More »
Q: For patients in the emergency department who present with a pulmonary concern, would a pulse oximetry reading performed after the initial intake reading be considered separately billable?Read More »
Q: If an anesthesiologist performs a presurgical or postsurgical block for pain control and it is performed in a holding area rather than in the operating room (OR), can we bill a separate facility (technical) fee for that? Or would this be bundled with OR services?Read More »
Q: My team and I are responsible for clinical documentation improvement (CDI). We’re considering adding a reconciliation element to our CDI review process next year. In your experience, what’s been the biggest benefit of performing reconciliation on charts?Read More »
