This note from the instructor explores the intricacies of the acute and post-acute transfer policy in light of recent OIG audits on hospital compliance with these policies.
This week’s Medicare updates include coding and payment information for the Johnson & Johnson COVID-19 vaccine, an OIG report on trends toward more expensive inpatient hospital stays, an MLN article on billing for services when Medicare is a secondary payer, and more!
Supporting accurate Hierarchical Condition Category (HCC) capture is essential to success under the growing number of risk-adjusted payment models. With their strong knowledge of coding and documentation guidelines and insight into emerging trends, coders are a key part of that strategy.
Q: As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) to InterQual. How will this affect organizations, and what can they do to smooth the transition?
Arthroscopic surgical procedures involve the insertion of a small scope into the interior of a joint, allowing the physician to view the joint without making a large incision through the skin. Review CPT coding for arthroscopic procedures of the hip and knee joints.
