Q: We are experiencing post-payment audits that result in denials of inpatient claims. Our coders and CDI leaders are vehement that the patient meets MCG and/or coding guidelines, but the payer is using clinical results from the patient as their justification. It seems as if they are ignoring...Read More »
Under the No Surprises Act, how do we document that a patient has been informed that a provider is out of network and still wishes to receive that provider’s services?Read More »
Q: Is there any CMS guidance on designation of patient provided/supplied drugs on claims, such as information on revenue codes, HCPCS codes, and quantity?Read More »
Q: How should we bill for trauma activation without pre-hospital notification and how should we capture charges for these services? Do we bundle the charge in with the facility evaluation and management (E/M) code?Read More »
