Nearly 42% of adults have medication interaction risks
Problems related to medication are a common cause of preventable hospital readmissions. A new study has shed light on a big problem area—nearly half of all adults drink even though the medication they...
View ArticleFate of "doc fix" bill remains unclear
Although the House overwhelmingly passed a bipartisan bill that would permanently fix the Sustainable Growth Rate (SGR) problem March 26, the bill’s future remains unclear as it lies in wait until the...
View ArticleCase managers identify critical topics in survey
Case managers across the country have some unique challenges these days. With new regulations and new pressures to prevent readmissions, some experts say their job is more difficult than ever...
View ArticleQ&A: Drug payments updated for April
Q: Did CMS make any changes to drug payments for April? A: CMS updated Addendum B with new payment information based on the updated average sales price information available. The updated rates are...
View ArticleWEDI survey reveals ICD-10 uncertainty
by Jaclyn Fitzgerald, Editor In a letter to HHS, the Workgroup for Electronic Data Interchange (WEDI) summarized the findings of its February 2015 ICD-10 readiness survey, which revealed uncertainty...
View ArticleEnsuring clear and concise documentation critical for case managers
Proper documentation is critical when it comes to supporting medical necessity and providing quality patient care. Case managers can be a crucial component when it comes ensuring documentation supports...
View ArticleSenate passes SGR bill, ICD-10 implementation date stands
By Melissa Varnavas Late in the evening Tuesday, April 14, Congress passed the Medicare and Children's Health Insurance Program (CHIP) Reauthorization Act (MACRA), effectively ending the 17-year battle...
View ArticleQ&A: We now receive edits on certain skin substitutes
Q: We have been reporting skin substitutes with the appropriate procedure codes (either CPT® or HCPCS C codes) with no problems. However, we are now receiving an edit that tells us we have a mismatch...
View ArticleCMS, ONC release EHR Incentive Programs and 2015 Edition Health IT...
The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released two proposed rules designed to improve care delivery and...
View ArticlePoll: Health problems are caused by more than just germs
American’s don’t think health is only about what happens to their bodies. They think it’s a result of outside experiences, according to a new poll by National Public Radio, the Robert Wood Johnson...
View ArticleQ&A: Rejections for codes without internal edits
Q: We are receiving rejections for HCPCS codes J0365 (injection, aprotonin, 10,000 kiu) and J7180 (injection, factor xiii [antihemophilic factor, human], 1 i.u) when we report them on a claim. We are...
View ArticleCMS focuses on quality measures in FY 2016 IPPS proposed rule
CMS released its fiscal year (FY) 2016 IPPS proposed rule April 17, announcing potential changes to MS-DRGs, the market basket update, and value-based payment quality measures. CMS proposed refining...
View ArticleExperts take on ED case management questions
The emergency department (ED) case manager has a number of critical functions in any hospital. During HCPro’s February webcast “Emergency Department Case Management: Manage Challenging Patients and...
View ArticleQ&A: Requirements for drug panels ordered in the ED
Q: When a patient presents to the ED and the physician there orders a drug panel, we perform the entire panel. Is that physician supposed to only order the tests for drugs that he or she suspects the...
View ArticleFlorida Hospital Orlando received more than $11 million in Medicare overpayments
by Jaclyn Fitzgerald, Editor Florida Hospital Orlando may have received more than $11 million in overpayments from Medicare from January 1, 2011, through June 30, 2012, according to a recently released...
View ArticleHospital goes lean to improve discharge process
Businesses have been going lean for years—relying on management principles that are designed to eliminate waste and streamline delivery. Healthcare has followed suit, using these management principles...
View ArticleQ&A: Reporting drug codes with no G code crosswalk
Q: I have a question about reporting drug tests to CMS for CPT® codes that do not have a crosswalk to the HCPCS G codes CMS introduced. For example, which code should we report to Medicare for code...
View ArticlePonemon study identifies criminal attacks as leading cause of breaches
by Jaclyn Fitzgerald, Editor Criminal attacks on the healthcare industry have increased 125% since 2010, making these attacks the leading cause of data breaches in the industry, according to the...
View ArticleNew resource can help boost patient health literacy
Adequate health literacy is a critical for patients leaving the hospital setting for the next level of care. Once patients leave, they’ll need to understand their condition well enough to follow...
View ArticleQ&A: We included a procedure on an inpatient claim before the patient was...
Q: We erroneously included a surgical inpatient-only procedure on an inpatient Medicare claim and don’t know how to handle this. The physician performed the procedure the day before the patient was...
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