It’s hard to believe planning for the 2019 Revenue Integrity Symposium (RIS) is already underway. It feels like just yesterday we were all gathered in Phoenix exchanging ideas, learning about the latest regulatory changes, and soaking up that desert sun at 2018 RIS. The symposium is NAHRI’s official annual conference and you do not want to miss what we have in store this year.
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?
CMS released additional instructions to the Medicare Claims Processing Manual for the accurate interpretation of claim edits and assignment of modifiers -59 and -91 on Medicare Part B claims.
With healthcare costs on the rise, patients are experiencing greater out-of-pocket expenses and providers, in turn, are having difficulty collecting revenue from patients-- a process...
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?
Most inpatient rehabilitation facility stays might not meet Medicare coverage or documentation requirements and compliance could be improved through a preauthorization process, according to a recent Office of Inspector General report.
