Coders can raise the flag for the risk management department by signaling unexpected patient care occurrences, such as a nicked organ during surgery. Use this sample occurrence report form as a template for your organization.
Q: How can we submit a claim that hits an edit for a noncovered procedure? Can we submit a claim for the covered procedures? Can we appeal if the provider believes the procedure should be covered?
Hospitals, health systems, and long-term care facilities are being challenged by census workers requesting information about patients and residents to conduct an accurate census. Some have gone as far as stating that they have a right to access hospital electronic health records (EHR).
As organizations respond to the COVID-19 pandemic, a growing number are turning to telemedicine to safely meet patient demand. “The current crisis is expanding people’s willingness to shift the paradigm both on the provider and patient side,” says Diane Iverson, RN, BSN, BS, ACM, CCM, a Baltimore-area case manager. “Systems are gearing up to expand services rapidly.”
Q: When would you use the ICD-10-CM codes for opioid or marijuana use when no mental, behavioral, or other disorder is connected? I’m specifically thinking of codes F11.90 (opioid use, unspecified, uncomplicated) and F12.90 (cannabis use, unspecified, uncomplicated).
Q: Regarding patient portals, to what degree is it the individual’s responsibility to keep his or her health information private? Would the healthcare organization be liable if someone else obtained the individual’s login credentials—perhaps if the individual is known to use the same password for many applications—and accessed the records?
