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Journal Q&A (9/04)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: September 02, 2004


Q: We are having trouble with the discharge status codes on some of our claims. In order to get the claim paid, the fiscal intermediary (FI) requires the discharge status code be changed. If we change the code, it will not correspond with documentation in our medical record.
A: The Center....

Journal Q&A (9/04)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: September 02, 2004


Q: We are having trouble with discharge codes 03 and 04 for skilled nursing facility and intermediate care facilities. I don’t think we have skilled nursing facilities in our area, so we have used the discharge code for intermediate care facility when a patient goes to the nursing home. <....

Laying the Foundation for the NHII

Author: Featheringham, Meg

Source: Journal of AHIMA

Publication Date: May 2004


The news is spreading across the country about the need for a national healthcare information infrastructure (NHII). HIM professionals are crucial to getting the word out and moving this initiative forward. Gail Graham, RHIA, is at the forefront of the charge to implement an NHII. As director....

Analysis of Final Rule for 2004 Revisions to the Medicare Hospital Outpatient Prospective Payment System

Author: AHIMA Policy and Government Relations Team

Source: AHIMA regulation analysis

Publication Date: December 02, 2003


The final rule regarding calendar year 2004 revisions to the Medicare hospital outpatient prospective payment system (PPS) was published in the November 7, 2003 issue of the Federal Register (the proposed rule was published in the August 12, 2003 issue). This rule becomes effective on January....

ABNs--Always Been Neglected

Author: Dunn, Rose T

Source: AHIMA community resource

Publication Date: November 14, 2003


For something that has been around for nearly 2 decades and supported by regulation since 1965, Advance Beneficiary Notices (ABNs) continue to cause headaches today. The use of written notices has been available since the enactment of PL 92-603 in 1972. The specific format called an Advance B....

Journal Q&A (7/03)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: July 02, 2003

Q: How can I find the Medicare manuals, program memorandums, and the Conditions of Participation on the new CMS Web site?

A: After the Health Care Financing Administration (HCFA) changed its name to CMS, it moved all its resources to its new site at www.cms.gov/manuals.


....

Teach Your Attorney Healthcare Contracting

Author: Le, Huan N.

Source: Journal of AHIMA

Publication Date: February 2003


Medicare regulations, HIPAA compliance, and the threat of litigation have made it impossible to draft a one-page healthcare contract. Standard language alone now extends to up to four pages. It’s a good idea to hire an attorney for contract negotiations and drafting, but even then, you mi....

Analysis of Final Rule for 2003 Revisions to the Medicare Hospital Outpatient Prospective Payment System

Author: AHIMA Policy and Government Relations Team

Source: AHIMA regulation analysis

Publication Date: November 24, 2002

The final rule regarding calendar year 2003 revisions to the Medicare hospital outpatient prospective payment system (PPS) was published in the November 1, 2002 issue of the Federal Register.   This rule becomes effective on January 1, 2003.   This analysis will cover significant....

Journal Q&A (11/02)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: November 02, 2002


Q: Where can I find federal regulations, interpretive guidelines, and Medicare manuals online?


A: The Centers for Medicare & Medicaid Services (CMS) has a number of manuals available online including the federal regulations for various settings, interpretive guidelines, Med....

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....

Web FAQ

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: October 2002

What guidance is available for determining an organization's definition of "attending physician" or "physician of record"?
The Department of Health, Education, and Welfare adopted the UHDDS (Uniform Hospital Discharge Data Set) as department policy for Medicare and Medicaid patient populations....

Web FAQ

Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

Where Can I Find the Regulations on Medicare Payment Methodologies Used in Non-acute Care Settings?


http://www.hcfa.gov/medicare/payment.htm is a site that provides links to pages on Medicare payment methodologies. On these pages you will find helpful information on various payment....

Laboratory Services Regulations Carry HIM Implications

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: September 2002


This is Part 1 of a two-part article on national coverage and policies for clinical diagnostic laboratory services payable under medicare Part B. Part 1 concentrates on the administrative policies. Part 2, which will appear in the October issue of the Journal, will focus on the national covera....

Journal Q&A (6/02)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: June 02, 2002

Q: Recently, a discharged patient fell two days after discharge from the inpatient rehab facility where I work. He went to the emergency room and was readmitted to the rehab facility within three days after discharge. Because we discharged the patient home without expecting a return, can we send in....

Make Clinical Research Top Priority

Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: January 2002


Whenever biomedical or behavioral research is conducted and supported by government agencies, it’s critical to comply with federal regulations designed to protect human subjects. For compliance officers, this means understanding and constantly monitoring a number of federal laws, regulati....

Experiences of a VHA Privacy Officer

Author: Putt, Stephanie H.

Source: In Confidence (newsletter)

Publication Date: November 02, 2001


Being the privacy officer for one of the world’s largest healthcare delivery systems is often a daunting responsibility, yet it offers an opportunity to make a difference and face new challenges. The Veterans Health Administration, or VHA, is part of the Department of Veterans Affairs (VA). T....

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