Skilled Nursing - Articles

Medical ID Theft
August 16th, 2019 - Namas
Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...
The OIG Work Plan: What Is It and Why Should I Care?
August 9th, 2019 - Namas
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
5 Ways to Minimize HIPAA Liabilities
July 12th, 2019 - BC Advantage
Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...
How to Properly Report Monitoring Patients Taking Blood-thinning Medications
June 18th, 2019 - Wyn Staheli, Director of Research
Codes 93792 and 93792, which were added effective January 1, 2019, have specific guidelines that need to be followed. This article provides some guidance and tips on properly reporting these services.
Spinal Cord Stimulator Used for Chronic Pain
April 1st, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Chronic pain is a condition that can be diagnosed on its own or diagnosed as a part of another condition. When coding chronic pain, there is no time frame defining when pain becomes chronic pain; the provider’s documentation should be used to guide the use of these codes. ICD-10-CM Diagnosis Codes ...
Pain Codes in ICD-10-CM
March 27th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
When coding with ICD-10-CM, pain codes can be found in different sections: The Body System affected or site-specific pain codes, such as Low Back Pain M54.5, can be found in Chapter 13. Diseases of the Musculoskeletal system (M00-M99). Other examples might be ocular pain H57.1, found in Chapter 7. Diseases of ...
Q/A: Coding for Lesion Removal and Repair
June 5th, 2018 - Chris Woolstenhulme QCC, CMCS, CPC, CMRS
The CPT book does not indicate repairs, measuring .5 cm and less, during lesion removal. Does this mean that...
Documentation for Skilled Nursing Facilities
March 8th, 2018 - Medicare Learning Network
The Medicare Learning Network provides guidance on required documentation for Skilled Nursing Facilities (SNF).
Billing Negative Pressure Wound Therapy (NPWT) (disposable device)
January 4th, 2018 - Find-A-Code
Per CMS: Disposable NPWT services are billed using the following Current Procedural Terminology® (CPT®) codes: 97607 - Negative pressure wound therapy, (e.g., vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surface area less than or ...
Special Skilled Nursing Facility (SNF) Billing Exceptions for Laboratory Tests PUB-100 40.4
January 4th, 2018 - Find-A-Code
When a SNF furnishes laboratory services directly, it must have a Clinical Laboratory Improvement Act (CLIA) number or a CLIA certificate of waiver, and the laboratory itself must be in the portion of the facility so certified. Normally the A/B MAC (A) makes payment under Part B for clinical laboratory ...
Elderly Abuse Discovered by the OIG - Early Alert
August 29th, 2017 - Chris Woolstenhulme, CPC, CMRS
The OIG sent out an early alert in an effort to create awareness to potential abuse or neglect of Medicare Beneficiaries in skilled nursing facilities. The OIG identified 134 Medicare beneficiaries whose injuries may have been the result of potential abuse or neglect. The beneficiaries reported were treated at the ...
Increased Medicare payment rates for FY 2018!
August 4th, 2017 - Chris Woolstenhulme, CPC, CMRS
We can look forward to a few prospective payments for Skilled Nursing Facilities, Hospice and Inpatient Rehab; CMS released their final rule and reported on key highlights of the new FY 2018 Medicare payment rules. CMS States, “The 2018 Skilled Nursing Facility (SNF) Prospective Payment System Final Rule increases Medicare payment rates ...

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