Revenue Cycle Daily Advisor -- July 11, 2017

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Tuesday, July 11, 2017

News

Case manager, social worker caught in $160K Medicaid scam

Source: Revenue Cycle Advisor

A case manager and social worker from Florida were recently arrested for billing Medicaid for $160,000 in fraudulent charges, according to the Orlando Sentinel. The pilfering pair were engaged to be married.

Hospital revisits often follow observation stays

Source: HealthLeaders Media

At 30 days post-discharge, one in five observation status patients had a revisit, such as an ED stay, another observation stay, or inpatient stay.

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Revenue Cycle Advisor Subscriber Content

CMS’ QPP proposed rule deserves consideration from providers and hospitals

Source: Revenue Cycle Advisor

In late June, CMS released a major proposed rule that hospitals will need to pay attention to—and no, I don’t mean to say that CMS released the CY 2018 OPPS proposed rule early, though we’ve thought that might happen since it’s been at the Office of Management and Budget (OMB) for several months.

Daily Q&A

Q&A: Choosing a principal diagnosis between anemia and malignancy

Source: ACDIS

Q. If a patient is admitted for anemia related to a malignancy and is treated only for anemia, the principal diagnosis goes to the malignancy. I understand that the malignancy was the root cause of the condition making it the principal diagnosis, but what if the patient was treated for other conditions besides anemia at the same time? Could you still code for the malignancy as the principal diagnosis?

Need expert advice?
Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.

Upcoming CMS Events

Wednesday 7/12 - Creating and Verifying Your National Provider Identifier Call

Tuesday 7/25 - Network & Events Revised Interpretive Guidance for Nursing Homes and New Survey Process Call

Wednesday 7/26 - ESRD QIP: Proposed Rule for Payment Year 2021 Listening Session

Monday 7/31 - Public Meeting Regarding New and Reconsidered Clinical Diagnostic Laboratory Test Codes

Product Spotlight

Achieve Compliance Through Ethical Coding Standards

With all the daily challenges and pressures within the coding world, ethical standards can get lost in the shuffle. During this 90-minute webinar, expert speaker Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-approved ICD-10-CM/PCS trainer, will provide an in-depth look at the principles of ethical coding and how to apply them to the daily workflow within revenue cycle departments.

What's New

The Physician Executive’s Role in Value-Based Transformation

An expert panel discusses essential strategies, tools, and tactics for physician executives tasked with navigating value-based payment models.

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