Subsequent Observation Services
CPT® released three new E/M services in 2011, to be used for the second and subsequent days that a patient is in observation status in the hospital.
The codes are 99224--99226 and they are out of sequence in the CPT® book. They require the same level of documentation as the three subsequent hospital visits.
99224 requires 2 of 3 of a problem focused interval history, problem focused exam and straightforward or low medical decision making. The typical time is 15 min...
Right Heart Catherization & Endomyocardial Biopsy
This is new on the 2014 OIG workplan. If you perform heart transplants in you institution you may want to review your policies and procedures. Make sure that your procedures are accurately documented. If you perform both procedures and use the -59 modifier your report should reflect the results from both procedures....
Yet another new auditor looking at Part B claims
Recovery Audit Contractors (RACs) may be about to take a break while CMS awards new contracts, but don’t rest on your laurels. CMS has handed out yet another auditor contract for a single auditor, known as a Supplemental Medical Review Contractor (SMRC) to do nationwide claims reviews for issues identified as being at risk for high dollar errors.
For Part B providers, the biggest target the new auditor, Strategic Health Solutions of Omaha, Neb., has identified is E/M claims billed with ...