Q: Our system has a new vendor that is helping with charge capture. We were discussing surgery level charges and a comment was made about rounding that surprised me: We don't have to follow rounding rules to select the additional 15 minutes after the first hour. The vendor acknowledged that Medicare does have rounding rules, but because the rounding rules are not listed in or specifically tied to any surgery documentation, then the rounding rules don't apply to surgery. If the total surgery time was 61 minutes, then we would have one first hour charge and one additional 15-minute charge. The vendor assured us that this was a common practice throughout all hospitals. Is this true?
On the latest episode of The Revenue Integrity Show: A NAHRI Podcast, listeners were treated to in-depth discussions on two of the hottest topics in the industry — updates to the inpatient-only list and price transparency.
Six codes for telehealth services are newly eligible to reported with modifier -CS (cost-sharing), which requires Medicare to cover beneficiary cost-sharing during office visits and other encounters for the duration of the public health emergency.
The NAHRI Illinois Local Chapter hosted its inaugural webinar on Thursday, February 18, 2021. The webinar included information about the Local Chapter, as well as a presentation on outpatient clinical documentation integrity.
Q: What revenue code should be attached to HCPCS codes M0239 (intravenous infusion, bamlanivimab-xxxx, includes infusion and post administration monitoring) and M0243 (intravenous infusion, casirivimab and imdevimab includes infusion and post administration monitoring)? We set it up as revenue code 260 but are getting edits to change it to 771. What are your thoughts and suggestions?
NAHRI’s January 26 Quarterly Call featured important association updates, as well as presentations on the new price transparency requirements and the 2021 OPPS final rule.
