Loading ...
Sorry, an error occurred while loading the content.

RE: [CRN-L] Re: question for hospital outpatient coders

Expand Messages
  • Christina Benjamin
    Thank-you so much for your help! Christina _____ From: CRN-L@yahoogroups.com [mailto:CRN-L@yahoogroups.com] On Behalf Of Mimi Tytko Sent: Wednesday, February
    Message 1 of 7 , Mar 2, 2007
    • 0 Attachment
      Thank-you so much for your help!

      Christina

      _____

      From: CRN-L@yahoogroups.com [mailto:CRN-L@yahoogroups.com] On Behalf Of Mimi
      Tytko
      Sent: Wednesday, February 28, 2007 2:27 PM
      To: CRN-L@yahoogroups.com
      Subject: [CRN-L] Re: question for hospital outpatient coders



      Also try:

      Medicare Conditions of Participation for Hospitals

      http://a257.
      <http://a257.g.akamaitech.net/7/257/2422/12feb20041500/edocket.access.gpo.go
      v/cfr_2004/octqtr/pdf/42cfr482.24.pdf>
      g.akamaitech.net/7/257/2422/12feb20041500/edocket.access.gpo\
      .gov/cfr_2004/octqtr/pdf/42cfr482.24.pdf
      <http://a257.
      <http://a257.g.akamaitech.net/7/257/2422/12feb20041500/edocket.access.gpo.go
      v/cfr_2004/octqtr/pdf/42cfr482.24.pdf>
      g.akamaitech.net/7/257/2422/12feb20041500/edocket.access.gp\
      o.gov/cfr_2004/octqtr/pdf/42cfr482.24.pdf>

      (c) Standard: Content of record. The medical record must contain
      information to justify admission and continued hospitalization, support
      the diagnosis, and describe the patient's progress and response to
      medications and services.

      (1) All entries must be legible and complete, and must be authenticated
      and dated promptly by the person (identified by name and discipline) who
      is responsible for ordering, providing, or evaluating the service
      furnished.

      (i) The author of each entry must be identifed and must authenticate his
      or her entry.

      (ii) Authentication may include signatures, written initials or computer
      entry.

      42 CFR 410.32

      http://www.cms.
      <http://www.cms.hhs.gov/ClinicalLabFeeSched/downloads/410_32.pdf>
      hhs.gov/ClinicalLabFeeSched/downloads/410_32.pdf
      <http://www.cms.
      <http://www.cms.hhs.gov/ClinicalLabFeeSched/downloads/410_32.pdf>
      hhs.gov/ClinicalLabFeeSched/downloads/410_32.pdf>

      § 410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and
      other diagnostic tests: Conditions.

      (a) Ordering diagnostic tests. All diagnostic x-ray tests, diagnostic
      laboratory tests, and other diagnostic tests must be ordered by the
      physician who is treating the beneficiary, that is, the physician who
      furnishes a consultation or treats a beneficiary for a specific medical
      problem and who uses the results in the management of the
      beneficiary's specific medical problem. Tests not ordered by the
      physician who is treating the beneficiary are not reasonable and
      necessary (see § 411.15(k)(1) of this chapter).

      [Non-text portions of this message have been removed]





      [Non-text portions of this message have been removed]
    • Christina
      Thank-you Jo Ann. I thought it might have something to do with Joint Commission or the Medicare CoPs, but I just could not put my finger on it. Thanks! ...
      Message 2 of 7 , Mar 2, 2007
      • 0 Attachment
        Thank-you Jo Ann.
        I thought it might have something to do with Joint Commission or the
        Medicare CoPs, but I just could not put my finger on it.

        Thanks!
        --- In CRN-L@yahoogroups.com, Jo Ann Steigerwald <jsteigerwald@...>
        wrote:
        >
        >
        >
        > I believe that what you are looking for is a JCAHO requirement.
        JCAHO
        > requires written orders for any test that is being done by the
        > hospital. JCAHO regulations however do not address billing,
        issues but
        > since a test cannot be done without a written order, one would
        have to
        > conclude that it also cannot be billed.
        >
        >
        >
        >
        > >From: <mailto:CRN-L%40yahoogroups.com>CRN-L@yahoogroups.com
        > >[mailto:CRN-L@yahoogroups.com] On Behalf Of
        > >Christina
        > >Sent: Wednesday, February 28, 2007 8:31 AM
        > >To: <mailto:CRN-L%40yahoogroups.com>CRN-L@yahoogroups.com
        > >Subject: [CRN-L] question for hospital outpatient coders
        > >
        > >Hi everyone,
        > >As a consultant, I am trying to identify the official written
        > >documentation that gives requirements for outpatient or ancillary
        > >testing in the hospital outpatient setting.
        > >
        > >I am looking for documentation from Medicare or some other major
        > >authority that states that it is a requirement for every
        outpatient
        > >account to include M.D. orders in the account and that would say
        > >something to the effect that an outpatient account shoudl not be
        billed
        > >if a M.D. order is not present for that encounter. Is there such a
        > >ruling or regulation out there?
        > >
        > >I have searched and cannot seem to find what I am looking for. If
        > >there is anything specific to electronic records I would love to
        see
        > >that also.
        > >
        > >Thanks for any help!
        > >Christina
        > >
        > >----------------------------------------------------------
        > >"This electronic message transmission contains confidential or
        privileged
        > >information from Mount Carmel . The information is intended for
        use by the
        > >individual or entity named above. If you are not the intended
        recipient,
        > >be aware that any disclosure, copying, distribution or use of the
        contents
        > >of this information is prohibited. If you have received this
        electronic
        > >transmission in error, please notify us immediately by telephone
        > >(614-234-8700) or by electronic mail
        > >(<mailto:exchange%40mchs.com>exchange@...)."
        >
        >====================================================================
        ==========
        > >
        > >[Non-text portions of this message have been removed]
        > >
        > >
        >
        >
        > [Non-text portions of this message have been removed]
        >
      • Christina
        Thank-you le! Christina ... diagnostics in ... Behalf Of ... outpatient ... billed ... see ... privileged information from Mount Carmel . The information
        Message 3 of 7 , Mar 2, 2007
        • 0 Attachment
          Thank-you le!
          Christina
          --- In CRN-L@yahoogroups.com, "Hamilton, le" <ghamilton2@...>
          wrote:
          >
          > Try Medicare 42 C.F.R. 410.28. This addresses outpatient
          diagnostics in
          > the hospital setting. Hope this helps.
          >
          >
          >
          > le Hamilton, CPC, CPC-H
          >
          > Compliance Specialist
          >
          > Chargemaster
          >
          > 614-546-4083
          >
          > _____
          >
          > From: CRN-L@yahoogroups.com [mailto:CRN-L@yahoogroups.com] On
          Behalf Of
          > Christina
          > Sent: Wednesday, February 28, 2007 8:31 AM
          > To: CRN-L@yahoogroups.com
          > Subject: [CRN-L] question for hospital outpatient coders
          >
          >
          >
          > Hi everyone,
          > As a consultant, I am trying to identify the official written
          > documentation that gives requirements for outpatient or ancillary
          > testing in the hospital outpatient setting.
          >
          > I am looking for documentation from Medicare or some other major
          > authority that states that it is a requirement for every
          outpatient
          > account to include M.D. orders in the account and that would say
          > something to the effect that an outpatient account shoudl not be
          billed
          > if a M.D. order is not present for that encounter. Is there such a
          > ruling or regulation out there?
          >
          > I have searched and cannot seem to find what I am looking for. If
          > there is anything specific to electronic records I would love to
          see
          > that also.
          >
          > Thanks for any help!
          > Christina
          >
          >
          >
          >
          > -------------------------------------------------------------------
          -----------
          > "This electronic message transmission contains confidential or
          privileged information from Mount Carmel . The information is
          intended for use by the individual or entity named above. If you
          are not the intended recipient, be aware that any disclosure,
          copying, distribution or use of the contents of this information is
          prohibited. If you have received this electronic transmission in
          error, please notify us immediately by telephone (614-234-8700) or
          by electronic mail (exchange@...)."
          >
          =====================================================================
          =========
          >
          >
          > [Non-text portions of this message have been removed]
          >
        Your message has been successfully submitted and would be delivered to recipients shortly.