Thursday, December 1, 2016

AHA pens letter to Trump calling for support of hospital policies

Written by Emily Rappleye   | November 30, 2016

The letter called on Mr. Trump not to make any abrupt changes or to repeal the ACA without a replacement plan, and it outlined the following five areas of healthcare policy for Mr. Trump to consider."To help advance health in America, we ask that your administration — in collaboration with Congress and the courts, and in partnership with healthcare providers — help modernize the public policy environment to enhance providers' ability to improve care and make it more affordable for patients," wrote Richard Pollack, president and CEO of AHA.
1. The AHA called for some regulatory trimming and pruning. They specifically called for the elimination of Stage 3 meaningful use for hospitals, implementation of a penalty for high rates of incorrect denials under the Recovery Auditor Contractor program, protection of clinical integration arrangements under the Anti-Kickback Statute, standardization of the Federal Trade Commission's merger review process and elimination of several post-acute care regulations.
2. The organization called for the President-elect's support on several financial policies. These include addressing drug prices, protecting the 340B Drug Pricing Program, challenging mergers among payers and considering Medicare reforms, such as raising the eligibility age.
3. It asked the Trump administration to consider redesigning many quality reporting requirements. The AHA wrote that requirements are excessive, redundant and not always meaningful. Notably, it called for suspension of the hospital star ratings on the Hospital Compare website.
4. The AHA urged Mr. Trump to ensure access to care in his healthcare policies. Particularly, the hospital association pointed to continued funding for CHIP, expanded mental health services, elimination of site-neutral payment cuts and establishment of a permanent Veterans Choice Program, which allows veterans to access care outside of the VA health system.
5. The association also called for the preservation of value-based care models adopted under the ACA. The AHA asked that several models be updated, including several ACO requirements and the advanced alternative payment models under the Medicare Access and CHIP Reauthorization Act.
"We look forward to working with you and your administration on public policy solutions to achieve our vision of a society of healthy communities where all individuals reach their highest potential for health," Mr. Pollack concluded.

Tuesday, November 29, 2016

Don't Wait! $1499 RN-Coder COMBO Ends Nov. 30th!


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Monday, November 14, 2016

Compliance Question of the Week

Cardiology

For the Week of November 14, 2016

If the doctor places a drug-eluting stent (DES) in the left anterior descending (LAD) artery and also does an angioplasty only of a diagonal artery, would the appropriate coding for a Medicare patient be C9600 and 92920 or C9600 and 92921?

If a DES is placed in the LAD, and separate angioplasty of a diagonal is performed, you would report the codes listed below. The angioplasty is in an additional branch of the LAD.

C9600Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
92921Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)

Friday, October 14, 2016

Horrifying Compliance Excuses!

Hi Joyce,
In my twenty years of professional work in the healthcare compliance field, I’ve heard some horrifying compliance excuses. For example, “Let’s just correct the problem moving forward, we don’t really need to go back and return money.” I was shocked the first time I heard that little doozy.
“Correcting from now on,” is a terrible attitude to have when it comes to overpayment. Is saving a little cash now worth owing millions later? Unfortunately, excuses like this are par for the course. As a compliance professional, I hear dozens of them, all the time. It’s a nightmare.
In the spirit of Halloween, download our free eBrief, "10 Compliance Horror Stories," for compliance excuses that will make you want to scream.
 

Trick or treat, 
CJ
<span class= 
CJ WolfMD, CHC, CPC, CCEP, CIA
Senior Compliance Executive
healthicity.com  |  email

Thursday, October 6, 2016

How hospitals code superbug

Has big impact on bottom line

The nuances of coding bacterial infections related to antibiotic-resistant superbugs can have a significant impact on hospital revenue streams, according to ICD10monitor.
A study published in the American Journal of Infection Control found hospital costs rose dramatically in cases where patients contracted different superbugs. Patients that contracted renal impairment increased treatment costs by an average of $8,942. 
Patients that contracted an immunocompromised status or concomitant antibiotic exposure increased treatment costs by $8,692 and $8,545, respectively.
Given the high cost of these cases and associated risk factors for contamination, ensuring correct identification, coding and nationwide tracking of superbug infections is critical, said ICD10monitor.

It is imperative hospital and physician coders stay up-to-date with changes to bacterial coding practices. 

Effective Oct. 1, codes for c. diff and MRSA changed to designate their status as hospital acquired infections. There are also ICD-10 codes for 22 different types of medication, including codes for resistance to medication, a condition that makes patient cases more difficult and costly to treat.
For more information on ICD-10 guidance updates from CMS, click here.

Sunday, September 25, 2016

What Happens on October 1st this year?!?!

END OF MEDICARE ICD10 "GRACE PERIOD".

https://youtu.be/Lp9a-SGZVm4

Do NOT use unspecific ICD10 codes!

Your diagnosis codes will start affecting payment January 1st!

Going forward, CMS & the third-party payers are "matching" your CPT codes with ICD10 codes
to build payment policies for the future.

The codes you submit now will affect current reimbursement & FUTURE reimbursement.

Check out this video -- very interesting!

Tuesday, September 20, 2016

RN-Coder Compliance Question of the Week

Can you provide some examples of chest manipulations and the documentation required to report the applicable codes?
Chest manipulations are described in CPT with examples such as cupping, percussing and vibration to facilitate lung function by mobilization of sputum. These services must be documented as reasonable and necessary to be covered, and there must be evidence of the following:
  • Consistent with the nature and severity of the individual’s symptoms and diagnosis
  • Reasonable in terms of modality, amount, frequency and duration of treatment
  • Generally accepted by the professional community as being safe and effective treatment for the purpose used.