Ask the Expert

Please explain the separate procedure exception for inpatient-only procedures.

What options for care/coverage does a patient have after receiving an Advance Beneficiary Notice?

Q: Has CMS added any DRGs to the post-acute transfer list beginning October 1?

Can hospitals report more than 48 hours of observation services?

What are the requirements for compliantly using condition code 44 to change a patient’s status?

Q: The influenza virus vaccine represented by CPT® code 90674 (influenza virus vaccine, quadrivalent [ccIIV4], derived from cell cultures, subunit, preservative and antibiotic free, 0.5 mL dosage, for intramuscular use) was approved under the Medicare program as of August 1. However, our claims are kicking back when we report the code. Has there been a change?

What’s the latest with regard to Beneficiary and Family Centered Care Quality Improvement Organizations short-stay reviews?

Is it appropriate for a critical access hospital hospital to bill with Type of Bill (TOB) 013X versus TOB 085X, or are they only to bill with 085X?