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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....

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....

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 - 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....

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