11 results.
Web FAQ
Author: AHIMA Professional Practice Team
Source: AHIMA Q and A
Publication Date: October 2002
What are the documentation requirements for Observation Patients?
It is interesting to note that the observation service (OBS) did not originate from the government but by the healthcare marketplace in response to PPS/DRG conditions. When hospitals are not sure whether a patient will meet admi....
Observation Services - Ensuring Every Dollar
Author: Canter, Kelly
Source: AHIMA Convention
Publication Date: October 02, 2011
Introduction
Inpatient medical necessity has become a very hot topic for the Recovery Audit Contractors (RACs) over the last 12 months. Due to the focus on medical necessity for inpatient admissions, proactive and reactive hospitals are scrutinizing their admission practices. Since there....
Injection and Infusion Coding Offers High Stakes: Outpatient Coders Must Play Their Cards Right
Author: Flewelling, Charles
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: June 2015
With the consistently rising value of highly skilled outpatient coders, numerous HIM departments are moving to a staffing model that employs coding professionals who are well versed in coding both inpatient and outpatient encounters. Coders in the profession today should possess a mastery....
Observation Services
Author: Hapner, Peggy
Source: AHIMA Convention
Publication Date: September 25, 2010
Observation is a necessary, though cumbersome, service provided in hospitals today. Many facilities would like to see observation eliminated because it is a logistical nightmare, particularly when it comes to charges and reimbursement.
The most stringent rules about observation....
Building Clarity on the Two-Midnight Rule
Author: Harris, Shelly; Kelly, Jeannie
Source: Journal of AHIMA - Coding Notes | Journal of AHIMA
Publication Date: October 2015
As the Centers for Medicare and Medicaid Services’ (CMS’) Probe and Educate Initiative draws to a close and the 2016 Outpatient Prospective Payment System (OPPS) proposed rules are released for comment, questions remain for the healthcare industry regarding expectations for selecting pati....
Observation Status or Inpatient Admission - Guidance for Physicians
Author: Health Care Excel
Source: External - used with permission
Publication Date: July 07, 2003
"Observation Status or Inpatient Admission - Guidance for Physicians" has been modified so that physicians can download all, or portions, through HCE’s website.
Observation
The quality of care should be the same whether the Medicare patient is placed in observation or admitted as an....
Reducing Outpatient Billed as Inpatient Errors
Author: Malone, Sue M.
Source: Journal of AHIMA - Coding Notes
Publication Date: February 2008
From 2006 to 2007, the Colorado Foundation for Medical Care (CFMC), the quality improvement organization (QIO) for Colorado, led a project to reduce the outpatient billed as inpatient billing error rate in five area hospitals. This article discusses the findings from the project, as well as be....
Coding Compliance Tips for Hospital Outpatient Observation Services
Author: Manning, Susan C.
Source: Journal of AHIMA
Publication Date: July 1999
The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) continues in its efforts to promote voluntarily developed and implemented compliance programs for the healthcare industry. Fundamentally, compliance efforts must be designed to establish a culture th....
Observation Services Present Compliance Challenges
Author: Prophet-Bowman, Sue
Source: Journal of AHIMA
Publication Date: March 2003
Observation services have been a top fraud and abuse target of the Office of Inspector General (OIG) of the Department of Health and Human Services, primarily due to the complexity of the Medicare billing regulations and the potential for abuse. New regulations regarding reimbursement for thes....
Outpatient Prospective Payment Becomes A Reality
Author: Scichilone, Rita A
Source: Journal of AHIMA - Coding Notes
Publication Date: June 2000
Do you know your APCs? July 1, 2000, is the start date for the Ambulatory Payment Classification (APC) prospective payment system for Medicare reimbursement. CPT coding skills will directly affect revenue as the current Ambulatory Surgery Center (ASC) methodology is abandoned and mor....
New "MOON" — Observation Status Notification
Author: Wilson, Donna D
Source: CodeWrite | AHIMA newsletter article
Publication Date: September 2016
"Why do I owe so much money for my last hospital stay? I have Medicare; doesn't that cover everything?" Maybe you have heard this question before—possibly from your own grandparents. The Centers for Medicare and Medicaid Services (CMS) hears regularly from Medicare beneficiaries whos....