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?
The improper payment rate for routine venipuncture lab tests was 16.3% in 2018, representing more than $20 million, and medical necessity errors accounted 98.9% of the improper payments, according to CMS.
CMS recently reissued Special Edition MLN Matters 19002 to address lingering provider questions surrounding the application of the 2-midnight rule to total knee arthroplasty (TKA) claims. The MLN Matters article was originally released January 8 but was reissued January 24 to correct errors.
The National Association of Healthcare Revenue Integrity is currently seeking speakers to present at the 2019 Revenue Integrity Symposium, to be held October 15–16, 2019, at the Renaissance Orlando at SeaWorld in Orlando, Florida.
On January 29, NAHRI presented its first members-only quarterly call of the year, where members heard from revenue integrity experts on engaging clinical staff, chargemaster updates, and addressing denials at their root cause.
