Article Archive
Good Coding: Helps Your Agency Keep Its Revenue Bad Coding: Can Mean You Lose Your Revenue
PPS has always meant that “close enough” isn’t good enough. A digit off can be costly. Coding to the highest level of specificity can be complex and confusing. CMS has published Coding Guidelines and the Coding Clinic remains the source document for any coding questions. Per CMS and as per the Federal Register, “The Coding [...]
Read more...Billing Compliance, Q Codes, Edits and Audits: Compliance in the Home Health Industry an Update
CMS revised the requirements on “April 19, 2013 to delete “and indicating whether services were added to the HH plan of care by a physician who did not certify the plan of care” from the Provider Action Needed” section of MLN Matters numberMM8136 Revised. Implementation date remains: July 1, 2013 Please see the following updated [...]
Read more...HIPAA Rules and the HITECH Act- Patient Privacy
Compliance officers were awaiting the Office of Civil Rights (OCR) final rules on Breach Notification, Enforcement, and the modification to Privacy and Security Rules of HIPAA HITECH. Now that we have the regulations, it is time to review the basics in this ezine and additional requirements in the next article. HIPAA may be one of [...]
Read more...OCR and HIPAA
At a recent HIPAA seminar, the Office of Civil Rights (OCR) identified that they are evaluating HIPAA audit models. The present model requests certain records, reviews, cites errors/omissions and calls for corrective action. Privacy and security of Protected Health Information (PHI) is of primary concern especially in light of social media and mandated Electronic Medical [...]
Read more...ICD-9-CM and ICD-10-CM: Some Differences and Similarities
CMS is stating they expect 10% of all claims submitted to be denied with ICD-10 initially. Selecting and assigning accurate diagnoses in the proper sequence must be performed in compliance with Medicare rules and regulations, Coding Conventions and Coding Guidelines. That remains the same. The accuracy of this information contained in the clinical record is [...]
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