Q: I was on a conference call with the CDM coordinators within my health system and we got involved in a lively discussion. If there's no medical necessity for observation, what do you do with charges? Our departments get productivity based on the charges posted. We all agreed that the...Read More »
Q: My team has asked me to look into charging for RF generator usage, which is about $850.00 per procedure. Is this something we can or should capture in the chargemaster?Read More »
Q: We are considering using of ICD-10 code Z79.899 (Other long term (current) drug therapy) to support medical necessity for lab testing while a patient is having chemotherapy. What is considered long term where this code is concerned?Read More »
Q: We recently had a consultant recommend that we create evaluation and management (E/M) levels for our labor and delivery observation cases, similar to our emergency room levels. Does anyone do this? If so, would you be willing to share your criteria and logic used?Read More »
Q: We have patients that come to the emergency department (ED), are seen by a physician assistant, nurse practitioner, doctor of osteopathic medicine, or medical doctor, have tests ordered, then leave before the tests results are given to the patient. Can the facility charge an ED visit or not...Read More »
Q: Considering the 2019 IPPS final rule requirement that hospitals post a list of their standard charges online, is it your interpretation that the standard chargemaster includes pharmacy and supplies?Read More »
Q: The physician documented debridement (11043x1 & 11046x4) of a wound 85.25 sq. cm and documented 20 sq. cm of skin substitute application (15271). My coder says that 11043/11046 is included in 15271 and we can't separately bill for them with 15271. Do we bill 15271 as the size of the...Read More »
