News & Analysis

July 1, 2017
Briefings on APCs

Our experts answer questions about MUEs on HCPCS codes, appealing claims for noncovered procedures, and more. 

June 30, 2017
News & Insights

Q: We use an electronic system at our hospital and find it is difficult to query a physician since we all have our own processes. Would you recommend having a set format for a query that is used electronically?

June 28, 2017
News & Insights

Q: Should we merge the care coordinator role in nursing with the RN case manager role in order to upgrade nursing care?

June 26, 2017
News & Insights

We have trouble billing multiple units of injections and infusions—mostly CPT add-on codes 96375 (injection, each additional sequential intravenous push of a new substance/drug) and 96376 (injection, each additional sequential intravenous push of the same substance/drug provided in a facility)—that are done during observation stays and exceed the medically unlikely edits number. What is the correct way to bill these and get paid?

June 23, 2017
News & Insights

Q: When multiple procedures are performed, is it appropriate to charge an additional set-up fee? For example, a facility performs a colonoscopy and an esophagogastroduodenoscopy, which took a total of 20 minutes in the procedure room. The facility charged two set-up fees plus an additional five minutes of OR time. Would this be considered a duplicate charge?

June 21, 2017
News & Insights

Q: How do ED case management roles differ from those on other units?

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