by kkluglein | Oct 15, 2021 | News, Tips & Expertise
Q: Are these for professional charges or facility?A: I know they can be different and get them confused sometimes. These are professional charges. Q: If two providers in the same group see the patient on the same date of service (day shift and night shift for...
by Kristi Pollard | Sep 17, 2021 | Blog, Tips & Expertise
Q: VitalWare is reporting that New Technology Add-on Payment for Abecma and Tecartus but they also drive to DRG 018. How does that work? A: This is correct. CAR T-cell therapies are assigned to MS-DRG 018 through a pre-MDC. Abecma and Tecartus both also receive...
by kkluglein | Sep 10, 2021 | Blog, Tips & Expertise
Q: For concurrent infusions, does the drug have to run 16 minutes together or any time together at all?A: Concurrent infusions should run greater than 16min together. Ref: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53778 Q: If Alteplase...
by Kristi Pollard | Aug 31, 2021 | Blog, Tips & Expertise
Q: Would you code long term use of insulin and hypoglycemic as well as presence of insulin pump? A: The code categories for diabetes, other than category I10 for type 1 diabetes, has a “use additional code” note indicating that the type of control (i.e., long term...
by Kristi Pollard | Aug 25, 2021 | Blog, Tips & Expertise
Q: O48.0 reads that it is for pregnancy over 40 completed weeks, so it seems that 40 weeks and 0 days would not be post term. There was a statement that post term is greater than or equal to 40 weeks. Are we interpreting that correctly? A: Post-dates pregnancy is...
by Kristi Pollard | Aug 20, 2021 | Blog, Tips & Expertise
Q: For the customizable interbody fusion device, is discectomy included or coded separately? A: Per the New Technology guidelines, the codes in the New Technology table report the only the steps of the procedure covered by that root operation. In table XRF, the...
