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?
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?
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?
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?
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?
