Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page
Is the work status external cause code required for correct coding even when an encounter does not specify work status, volunteer activity, student activity etc. etc. ? When such things are specified I code, however, for example, if a baby has a fall, would y99.9 be required for "correct coding".
Thanks
V. Cook, CPC
A final conscience rule issued May 2 by the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) has stirred up a hornets’ nest of controversy that has been lying dormant for years. The Protecting Statutory Conscience Rights in Health Care: Delegations of Authority final rule “protects individuals and health care […]
The post Conscience Rule Misconceptions Cause Controversy appeared first on AAPC Knowledge Center.
For quite a long time, Medicare and Medicaid have been included on a Government Accountability Office (GAO) rundown of government programs that are at an expanded danger of misrepresentation, waste, misuse, and bungle. GAO’s investigations of FY 2017 program activities that gauges $ 27.5 billion in inappropriate installments implies it will probably make the rundown again in one year from now’s report.
The GAO is an autonomous, neutral organization that works for Congress. Frequently called the “congressional guard dog,” GAO inspects how citizen dollars are spent and furnishes Congress and government organizations with reports to help survey the administrative government’s execution. As indicated by the report, the GAO appraises that Medicare expense for-administration made $ 23.2 billion in inappropriate installments while Medicaid made $ 4.3 billion.
To build up these assessments, CMS utilizes temporary workers to review an example size of cases. The reviews incorporate medicinal documentation audits to approve restorative need and adherence to CMS charging approaches. The contractual workers extrapolate patterns from the examples to extend the by and large ill-advised installment rate.
The report characterizes lacking documentation as “ill-advised installments in which suppliers submit documentation that is inadequate to decide if a case was legitimate, for example, when there is deficient documentation to decide whether administrations were medicinally important, or when a particular, required documentation component, for example, a mark, is absent.”
As per the GAO, inadequate documentation was referred to as the reason for 64 percent of Medicare and 57 percent of Medicaid inappropriate installments. Information from CMS uncovered that the general rate of deficient documentation over all administrations in FY 2017 was 6.1 percent for Medicare versus 1.3 percent in Medicaid. The report concentrated on this difference.
The GAO report likewise incorporates suggestions to CMS for improving the therapeutic audit procedure to all the more likely comprehend the ill-advised installment rate.
The post GAO Scrutinizes Insufficient Documentation as Cause for Improper Medicare and Medicaid Payments appeared first on The Coding Network.
Thoughts?
Thank you in advance!
Explanation of Medicare Benefits (EOB) error message 96 Non-covered charge was the No. 1 reason for claims denials in December in all of Medicare Jurisdiction H, according to the region’s Medicare Administrative Contractor (MAC). “Prior to performing or billing a service, ensure that the service is covered under Medicare,” Novitas Solutions says on their website. […]
The post Non-coverage Denials: Cause and Cure appeared first on AAPC Knowledge Center.
I would require ICD-10-CM clarification for External cause coding. The Nephrologist visits CKD patient in inpatient hospital who was admitted for femur fracture. The fracture occurred due to fall.
We are coding CKD codes with injury and external cause codes. I am not sure if we can code initial external cause codes for Nephrologist. The nephrologist is not involved in ortho treatment, should we code external cause codes for consultation services other than ortho/injury services?. Do we have any guidelines for this?
Regards,
SG
Thanks so much!
Pamela Johnson, BS, CPC