Laboratory Question for the Week of July 29, 2019
MedLearn Publishing
July 29, 2019
How does new research contradict the GAO’s assertions on lab billing?
How does new research contradict the GAO’s assertions on lab billing?
How is the HHS planning to replace the Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals?
Can you tell me the type of services that CMS considers administrative and are not separately billable?
How do MACs use data in the TPE program?
Regarding coronary intravascular ultrasound (IVUS), I understand if it is done prior to an intervention that we can bill it. It should be diagnostic, and the findings should document the vessel size and the medical necessity for performing the IVUS. Can I bill if it is done after an angioplasty to determine the size of stent that will be deployed? Our technical staff thinks that we should be charging these in addition to the stent.
I am in the process of setting fees up in our imaging center billing system for radiopharmaceuticals used in nuclear medicine procedures. The Medicare Physician Fee Schedule (MPFS) does not give payment amounts for radiopharmaceuticals. Do you know if and how they are paid?
Have we lost the art of telling the patient’s story? Coming off of two weeks of health information management (HIM) conferences and listening to presentations
Some payers will take back the fee-for-service payment if the wrong diagnosis code is selected. There have been many conversations had since the healthcare industry
Two-thirds of the 27 million annual ED visits by privately insured people in the U.S. are avoidable. Hospital emergency departments (EDs) have long been known as
Don’t preoccupy yourself with DRGs, CCs and MCCs. I don’t think about my previous life as a practicing physician much, but I took a little
Case managers could be at risk relative to discharge planning. While not significantly common, hospital case managers have been named in nursing malpractice suits, primarily
Rules and regulations are always changing. Many readers may remember the Centers for Medicare & Medicaid Services (CMS) Transmittal 534. This was released in early
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Stacey Shillito, CDIP, CPMA, CCS, CCS‑P, CPEDC, COPC. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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