Ten misconceptions about HIPAA privacy and security rules
by Jaclyn Fitzgerald, Associate editor With most of the provisions of the HIPAA omnibus rule now in effect, it is important for you to separate fact from fiction when it comes to HIPAA compliance....
View ArticleQ&A: Is -59 the only modifier for post-reduction x-rays?
Q: In the October 11 APCs Insider, you noted that modifier -59 (distinct procedural service) would be appended to the post-reduction x-ray to indicate it being separate and distinct from the...
View ArticleSNF Compliance: Maximize Quality and Minimize Financial Risk - Free Whitepaper
Section 6102 of the Resident Protection Affordable Care Act of 2010 required skilled nursing facilities (SNF) to establish a compliance and ethics program by March 23, 2013. Most of us have an existing...
View ArticleCMS memo emphasizes the need to provide life support
In an October 25 memo to state survey agency directors, the Centers for Medicare & Medicaid Services (CMS) announced that prior to the arrival of emergency medical services (EMS), nursing homesmust...
View ArticleGAO reports on progress of EHR Incentive Program payments
by Jaclyn Fitzgerald, Associate editorCMS awarded approximately $6.3 billion in Medicare EHR Incentive Program payments in 2012, according to a report released by the U.S. Government Accountability...
View ArticleQ&A: Can we bill separate doses of a drug on the same day?
Q: On occasion, a patient undergoes a cardiac stress test with myocardial perfusion and a stress echo on the same day. While this doesn’t happen often, we are seeing an increase in the frequency. Both...
View ArticleCDC study finds LTC workers last in receiving flu shots
In a recent report released by the Centers for Disease Control and Prevention (CDC), long-term care providers are in last place when it comes to the number of health care professionals that get the...
View ArticleStrong hospital-SNF relationships reduce readmissions
by Jaclyn Fitzgerald, Associate editorStronger links between hospitals and skilled nursing facilities (SNF) can reduce readmissions, according to a study published in Health Services Research....
View ArticleSurvey shows widespread support for NP services
A new survey from the American Association of Nurse Practitioners shows widespread, national support among the general public for legislative and policy proposals that give patients access to nurse...
View ArticleTip: Determining E/M levels in the ED
Determining E/M levels can be difficult in any circumstance, but ED cases can add further complications. The presenting problem, or chief complaint, starts the process of determining an ED E/M level....
View ArticleQ&A: Coding for ED patients who don't see physicians
Q: A patient presents to the ED and is just triaged. The patient received Motrin® and then left prior to seeing the physician. No physician will be signing off on the chart. We do have advanced nursing...
View ArticleCMS announces corrections to MDS 3.0 RAI User's Manual
On November 5, the Centers for Medicare & Medicaid Services (CMS) released corrections to the current version of the MDS 3.0 RAI User’s Manual. Corrections include (directly from CMS):1. The...
View ArticleCMS releases new ICD-10 resources
by Jaclyn Fitzgerald, Associate editorCMS recently released five online resources to aid providers in their ICD-10 implementation efforts. Although CMS designed some of these resources with providers...
View ArticleQ&A: Coding drug administration for observation patients
Q: An observationpatient received an IV push on the first day (9/28) and an infusion the next day (9/29). The department reported CPT® code 96374 (therapeutic, prophylactic, or diagnostic injection;...
View ArticleOIG study recommends developing new quality measure
A new Office of the Inspector General (OIG) study has recommended to the Centers of Medicare & Medicaid Services (CMS) that they develop a quality measure that describes nursing home resident...
View ArticleNew guidelines for preventing and remedying medical identity theft
by Jaclyn Fitzgerald, Associate editorThe State of California Department of Justice Office of the Attorney General recently released a report featuring new guidelines for the prevention and remedy of...
View ArticleAMA and AHA urge delay of 2-midnight rule
by Jaclyn Fitzgerald, Associate EditorThe American Hospital Association (AHA) and American Medical Association (AMA) are urging CMS to delay enforcement of the 2-midnight rule finalized in the 2014...
View ArticleCMS collapses clinic E/M codes, introduces more packaging
By Steven AndrewsCMS released the 2014 OPPS Final Rule November 27 and while not all of the sweeping changes from the proposed rule were finalized, CMS continued its move toward increased packaging,...
View ArticleQ&A: Are there new pass-through devices for 2014?
Q: We have started our charge description master (CDM) updates for 2014 and wonder if there will be any pass-through devices for next year. In the 2014 OPPS Proposed Rule, CMS noted that HCPCS codes...
View ArticleGAO issues report on state of ZPICs
A new report from the U.S. Government Accountability Office (GAO) finds that Zone Program Integrity Contractors (ZPICs) have stopped more than $250 million in savings to Medicare in calendar year 2012...
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