Being described as "worse" in a CMS HospitalCompare data file is a dubious distinction.
A recent HospitalCompare list identifies 292 hospitals with 30-day readmission rates that are the highest in the nation in at least one of three disease categories— acute myocardial infarction,...Read More »
It started with two courageous coders who knew the query process where they worked at Johns Hopkins Bayview Medical Center, Inc., in Baltimore, wasn't quite right--or compliant.
Specifically, the hospital employed a physician who worked in the billing department to review clinical...Read More »
Healthcare providers in the A/B MAC jurisdiction 1 have a problem—a paid claims error rate that’s nearly twice the national average for Part B claims, according to a recent letter from...Read More »
In 2007, CMS began monitoring claims for hospital-acquired conditions (HAC), which are conditions that occur after the physician writes the inpatient admission order and that could have been reasonably prevented through the application of evidence-based guidelines and best practices. Today,...Read More »
RACs can easily data-mine for noncompliance related to coding for ventilator support, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, independent revenue cycle consultant in Madison, WI. For example, patients whose length of stay is fewer than two days can’t...Read More »
by Glenn Krauss, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS
Because most CMS local and national coverage determinations governing medical necessity and limitations of coverage center around outpatient procedures (e.g., lesion removals, cataract surgeries, and blepharoplasty repairs),...Read More »