Q: We have some patients in our partial hospitalization program who need intensive care, but don’t always meet the minimum number of hours. One of our providers insists that some patients need the intensive care, but “just not that much time.”
Q: We have started receiving rejections for ED claims when the services involves removing impacted cerumen. We are reporting CPT® code 69209 (removal impacted cerumen using irrigation/lavage, unilateral) for each ear, and the documentation supports the irrigation/lavage rather than the physician removing the impaction with instruments. Our claims just started getting rejected in April.
Q: We have trouble billing multiple units of injections and infusions that are done during observation stays and exceed the medically unlikely edits number. What is the correct way to bill these and get paid?
