Q&A: Billing for observation services when using condition code 44

Wed, 06/13/2018
Revenue Integrity Insider - Volume 2 Issue 17
Ask NAHRI, Billing and Claims, Revenue Integrity

Q: In a condition code 44 scenario, may we report and bill for observation hours (revenue code 762) prior to the order for observation?Read More »

Revenue Integrity Q&A: Revenue codes, charge reconciliation, and Medicare HMO patient status rules

Wed, 06/06/2018
Revenue Integrity Insider - Volume 2 Issue 14
Ask NAHRI, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Revenue integrity professionals often run across tough questions. On the NAHRI Forums, revenue integrity professionals can get advice from peers...Read More »

Q&A: Billing anesthetic drugs with injection procedures

Wed, 05/30/2018
Revenue Integrity Insider - Volume 2 Issue 11
Ask NAHRI, Billing and Claims, Coding and Documentation, Compliance, Revenue Integrity

Q: Is it true that billing anesthetic drugs with injection procedures in outpatient clinic encounters is unbundling packaged services?Read More »

Q&A: Services included in room and board

Wed, 05/16/2018
Revenue Integrity Insider - Volume 2 Issue 10
Ask NAHRI, Billing and Claims, Coverage, Denials and Appeals, Revenue Integrity

Q: Is there any specific guidance on what nursing services should be included in room and board and covered under routine services?Read More »

Q&A: Pre-service coverage analysis for medical necessity

Wed, 05/02/2018
Revenue Integrity Insider - Volume 2 Issue 9
Ask NAHRI, Coverage, Monitoring and Audits, Revenue Integrity

Q: When a physician schedules a procedure, do you evaluate the patient’s record prior to the procedure to determine whether all of the coverage...Read More »

Q&A: Self-reporting device credits

Wed, 04/18/2018
Revenue Integrity Insider - Volume 2 Issue 8
Ask NAHRI, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Q: Over the last few weeks, there have been quite a few articles in various newsletters about device credits. I’m not sure we have the best...Read More »

Q&A: Medicare coverage of acupuncture

Wed, 04/04/2018
Revenue Integrity Insider - Volume 2 Issue 7
Ask NAHRI, Coding and Documentation, Coverage

Q: What modifier should we report for acupuncture? Does this service fall under statutorialy excluded or non-covered services?Read More »

Q&A: Charging for cancelled surgeries

Wed, 03/21/2018
Revenue Integrity Insider - Volume 2 Issue 6
Ask NAHRI, Billing and Claims, Chargemaster and Charge Capture, Compliance

Q: Can you charge a cancelled surgery if the patient is not taken to the procedure room?Read More »

Q&A: Responding to additional documentation requests for audits

Wed, 03/07/2018
Revenue Integrity Insider - Volume 2 Issue 5
Ask NAHRI, Monitoring and Audits, Revenue Integrity

Q: What is the best way to handle an additional documentation request for a pre-payment targeted probe and educate audit issue?Read More »

Q&A: Billing for therapy caps

Wed, 02/21/2018
Revenue Integrity Insider - Volume 2 Issue 4
Ask NAHRI, Revenue Integrity

Q: Are outpatient departments considered part of the therapy cap for hospital-owned facilities? If so, do we need to bill with modifier –KX (Type...Read More »

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