Q:I’ve been told that if there are clinical indicators to support that CKD is the etiology of a patient’s hypertension, a code from category I15 would be assigned. Code I12 is for hypertensive CKD, isn’t it? So why do we have...Read More »
Over the past couple months, ACDIS has been running a series of polling questions about the staffing in different departments—from nurses, to physicians, and now to coders.Read More »
Q: When a patient comes in with two diagnoses and the documentation reflects that either could be the principal diagnosis, do we choose the principal as the diagnosis that is being treated more intensely, or do we choose the higher paying DRG? Is it true that when a patient comes in...Read More »
Findings from a CERT study show that insufficient documentation caused most improper payments for chiropractic services billed to Medicare in 2018, according to the ...Read More »
Q: I’ve heard that the GMLOS is always rounded to the nearest whole number as inpatient claims are paid by day. Based on my understanding of the IPPS, I thought that each inpatient stay is paid by a fixed amount, regardless of the...Read More »
Providence Health & Services wasn’t the only one under fire from Integra Med Analytics. The firm also filed a suit alleging that Baylor Scott & White, a large Texas-based health system, wrongly billed Medicare for more than $61.8 million over seven years through the practice of upcoding...Read More »
