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 debridement documented or only the size of the skin substitute?
Q: How are you carving out other services from observation? Are you using a standard time or calculating based on the time off the nursing unit? What services are you carving out? Are you carving out services for other non-Medicare payers?
Q: Our facility is evaluating the pros and cons of charge on dispense vs. charge on administration for medications. Are there any best practices or guidelines for medication charging and documentation?
Revenue integrity professionals often run across tough questions. On the NAHRI Forums, revenue integrity professionals can get advice from peers and experts and learn about solutions others have discovered. Here are the questions that have sparked the most conversation.
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 requirements of the applicable National Coverage Determinations and/or Local Coverage Determinations are met?