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Domain > accretivepas.plumgrovedigital.com
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Date
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2017-04-19
54.85.122.47
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2024-08-07
34.202.191.79
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Port 80
HTTP/1.1 200 OKDate: Wed, 07 Aug 2024 20:44:08 GMTContent-Type: text/html; charsetUTF-8Transfer-Encoding: chunkedConnection: keep-aliveSet-Cookie: AWSALBG8cU25TPmhEAOULNl1vYmBSkXZAkTLQVuYLucFxyanRnWvEqFa2qVG1xzO7NsD0KYlULWvZirrgx3aieu3wPMKTL914un6di4hb/S1ZgnSBFsvzZNW5vLx5u4MSF; ExpiresWed, 14 Aug 2024 20:44:08 GMT; Path/Set-Cookie: AWSALBCORSG8cU25TPmhEAOULNl1vYmBSkXZAkTLQVuYLucFxyanRnWvEqFa2qVG1xzO7NsD0KYlULWvZirrgx3aieu3wPMKTL914un6di4hb/S1ZgnSBFsvzZNW5vLx5u4MSF; ExpiresWed, 14 Aug 2024 20:44:08 GMT; Path/; SameSiteNoneVary: Accept-EncodingSet-Cookie: PHPSESSIDl3v4sau5hcsesc4ro5jlq1142g; expiresThu, 07 Aug 2025 20:44:08 GMT; Max-Age31536000; path/; HttpOnlyExpires: Thu, 19 Nov 1981 08:52:00 GMTCache-Control: no-store, no-cache, must-revalidatePragma: no-cacheP3P: policyref/w3c/p3p.xml,CPCAO DSP COR CURa ADMa DEVa TAIa PSAo PSDo CONo TELo OUR DELo SAMo OTRo BUS IND PHY ONL UNI PUR COM NAV DEM STAVary: User-AgentPermissions-Policy: usb()Referrer-Policy: unsafe-urlCache-Control: no-store, no-cache, must-revalidate, post-check0, pre-check0X-Content-Type-Options: nosniffX-XSS-Protection: 1 !DOCTYPE html>html langen-US>head> script src//accretivepas.plumgrovedigital.com/html5_viewer/compiled/wrapper-min.js defer>/script> link relcanonical hrefhttp://accretivepas.plumgrovedigital.com/march-april-2015-vol-5-no-2/page-1?pp1 /> link typeapplication/rss+xml titleRSS relself hrefhttp://accretivepas.plumgrovedigital.com/publication/contents-rss.php?id_publication27236&k04dcb5cc0f2005faca74854dd02f00a70766ec1f /> link relhub hrefhttps://pubsubhubbub.appspot.com /> link relmanifest hrefmanifestjson.php?m27236 /> title>AccretivePas Update March/April 2015/Vol. 5, No. 2/title> script> if (location.hostname php7.mydigitalpublication.com || location.hostname testbranch.mydigitalpublication.com) { var swUrl /html5_viewer/service-worker.php; if (serviceWorker in navigator) { window.addEventListener(load, () > { navigator.serviceWorker.register(swUrl, {scope: /}) .then(async (reg) > { const start_url \/publication\/?m27236&l1; // Dont attempt to register start_url if we are at it because itll interfere with runtime caching. // Itll still get cached automatically by workbox later. let urls start_url, // location.origin + location.pathname + location.search, ; if (location.pathname + location.search ! start_url) { // urls.push(location.pathname + location.search); } // console.log(Service worker registered., reg); // console.log(registering, urls); const cache await window.caches.open(workbox-runtime- + location.origin + /); await cache.addAll(urls); }); }); } } var time (new Date()).getTime(); window.addEventListener(message, function(e) { try { var json JSON.parse(e.data); if (json.command datachange) { if(json.data && (json.data.name hideSplashScreen) && (json.data.value true)) { // console.log(hide splash screen, time, (new Date().getTime()), ((new Date()).getTime() - time) / 1000); document.getElementById(apploader).style.displaynone; } } } catch(exc) { // Dont crash } }); /script>meta namedescription contentAccretivePAS® UpDate Hospital Industry Newsletter features the latest Medicare and Medicaid news, commentaries and results of audits and regulatory rulings, hospital industry news and case management reports and information. > link relshortcut icon typeimage/png hrefhttp://img.coverstand.com/27236/logos/favicon.png/> meta propertytwitter:card contentsummary_large_image> meta propertyog:title contentAccretivePas Update March/April 2015/Vol. 5, No. 2 /> meta propertyog:description contentAccretivePAS® UpDate Hospital Industry Newsletter features the latest Medicare and Medicaid news, commentaries and results of audits and regulatory rulings, hospital industry news and case management reports and information. /> meta propertytwitter:description contentAccretivePAS® UpDate Hospital Industry Newsletter features the latest Medicare and Medicaid news, commentaries and results of audits and regulatory rulings, hospital industry news and case management reports and information. /> meta propertyog:type contentarticle /> meta propertyog:image contenthttp://img.coverstand.com/27236/250546/iphonejpg/960/f40b0ef1beaf0ad596e56a60be93f01306d816a7.jpg/> meta propertytwitter:image contenthttp://img.coverstand.com/27236/250546/iphonejpg/960/f40b0ef1beaf0ad596e56a60be93f01306d816a7.jpg/> meta propertyog:image:width content1024 /> meta propertyog:image:height content1325 /> meta propertyog:url contenthttp://accretivepas.plumgrovedigital.com/march-april-2015-vol-5-no-2/page-1?pp1 /> link relimage_src hrefhttp://img.coverstand.com/27236/250546/iphonejpg/960/f40b0ef1beaf0ad596e56a60be93f01306d816a7.jpg /> meta http-equivContent-Type contenttext/html; charsetutf-8 /> meta nameapple-mobile-web-app-capable contentyes /> meta nameapple-mobile-web-app-status-bar-style contentblack /> meta nameviewport contentinitial-scale1,user-scalableyes,maximum-scale5,widthdevice-width,viewport-fitcover> link relapple-touch-icon hrefhttp://img.coverstand.com/publication/repo21/27236/logos/iphone_icon_144.png /> style classcustom_css> /style> style> html { height: 100%; } body { margin: 0px; padding: 0px; overflow: hidden; background-color: black; height: 100%; } .seo { z-index: -1000; position: fixed; color: #000; background-color: #fff; } iframe { width: 100%; height: 100%; border: 0px; padding: 0px; margin: 0px; position: fixed; top: 0px; left: 0px; z-index: 1000; background-color: black; } #loader { display: block; position: fixed; z-index: 1001; height: 100%; width: 100%; background-color: black; } div#sizer { width: 100%; height: 100%; border: 0px; padding: 0px; margin: 0px; position: absolute; top: 0px; left: 0px; } #printDiv { display: none; } @media print{ @media (min-width: 0px) { /*Non-IE print page resizing*/ body * { max-width: 8.10in !important; } } body * { display: none; font-family: Open Sans ,Helvetica Neue, Verdana, Geneva, sans-serif !important; } #printDiv { display: block !important; width: 8.50in; max-width: 8.50in; margin: 0; padding: 0; float: none; text-align: center; background-color: #ffffff; } #articleBrowser .article-content *, #articleBrowser #containerTitle, #articleBrowser .article-title h2, #articleBrowser .article-title h3 { font-family: Open Sans ,Helvetica Neue, Verdana, Geneva, sans-serif !important; } #printDiv .print { -ms-interpolation-mode: bicubic; display: block; max-width: 8.10in; max-height: 10.60in; width: auto; height: auto; margin: 0 auto; } #printDiv .pageBreak { display: block; page-break-after:always; page-break-inside: avoid; } } /style> style> #apploaderIcon { height: 60px; width: 60px; } #apploaderCoverImg { max-width: 320px; } .loaderWrapper.alignmiddle { position: absolute; top: 50%; left: 50%; transform: translate(-50%, -50%); -webkit-transform: translate(-50%, -50%); } #apploader { position: fixed; height: 100%; width: 100%; z-index: 1001; background-color: gray; /*display: none;*/ } .spinner { margin: auto; flex: 0 0 auto; max-width: 60px; max-height: 60px; -webkit-animation: spin 2s infinite linear; -moz-animation: spin 2s infinite linear; -o-animation: spin 2s infinite linear; -ms-animation: spin 2s infinite linear; animation: spin 2s infinite linear; } @-webkit-keyframes spin { from { -webkit-transform: rotate(0deg); } to { -webkit-transform: rotate(360deg); } } @-moz-keyframes spin { from { -moz-transform: rotate(0deg); } to { -moz-transform: rotate(360deg); } } @-o-keyframes spin { from { -o-transform: rotate(0deg); } to { -o-transform: rotate(360deg); } } @-ms-keyframes spin { from { -ms-transform: rotate(0deg); } to { -ms-transform: rotate(360deg); } } @keyframes spin { from { transform: rotate(0deg); } to { transform: rotate(360deg); } } /style> script> var publicationId 27236; var issueId 250546; var state {issue_id:250546}; var options {issue_id:250546,publication_id:27236,latest:1,tempOptions:,subscriptionAction:redirect}; var domain accretivepas.plumgrovedigital.com; var referer null; var pageNumber null; var requestParams {m:27236,l:1,i:0,ver:html5,pjs:1}; var isMediaDeck false; //console.log(//); /script>/head>body>script> var preloadData {\preload\:{\@attributes\:{\collection_logo\:null,\logo\:\http:\\\/\\\/img.coverstand.com\\\/27236\\\/logos\\\/logo.png\,\thumb320\:\http:\\\/\\\/img.coverstand.com\\\/27236\\\/250546\\\/iphonejpg\\\/960\\\/f40b0ef1beaf0ad596e56a60be93f01306d816a7.jpg\,\replica_vertical_align\:null,\color1\:\\,\file\:\http:\\\/\\\/img.coverstand.com\\\/27236\\\/186524\\\/bg_image.jpg\,\method\:\stretch\}}};/script> div idloader aria-hiddentrue tabindex-1> /div> div classseo aria-hiddentrue tabindex-1> !-- issue--> h1>AccretivePas Update March/April 2015/Vol. 5, No. 2: Page 1/h1> p> img srchttp://img.coverstand.com/fit-in/300x300/27236/250546/iphonejpg/960/f40b0ef1beaf0ad596e56a60be93f01306d816a7.jpg stylemax-width: 100px; max-height: 100px; vertical-align: top; altAccretivePAS® UpDate Hospital Industry Newsletter features the latest Medicare and Medicaid news, commentaries and results of audits and regulatory rulings, hospital industry news and case management reports and information. > /p> nav>Menubr/>ul>li>a tabindex-1 href/march-april-2015-vol-5-no-2/pages>Page View/a>/li>li>a tabindex-1 href/march-april-2015-vol-5-no-2/articles>Contents View/a>/li>li>a tabindex-1 href/march-april-2015-vol-5-no-2/advertisers>Advertisers/a>/li>/ul>/nav>main>p>ACCRETIVE HEALTH UpDate Hospital Industry Newsletter ® MACs heading down a Slippery Slope from Medical Necessity to Quality of Care Ronald Hirsch, M.D. “Don’t confuse me with the facts; my mind is already made up.” This is how William Malm, the senior manager at Craneware describes the two recent notifications by two MACs who have made up their minds that they need to enter the realm of risk assessment and quality of care, a territory where they do not belong. My investigation of this was first inspired by denials of outpatient ureteral stents by CGS, the Jurisdiction 15 Medicare Administrative Contractor (MAC). In January, CGS posted to their web site the results of their probe audit of outpatient claims for ureteral stent, CPT code 52332. They reported an as-tounding 89% error rate on 99 reviewed claims, noting lack of medical necessity in the majority of cases. Realizing that most patients would not agree to ure-teral stent placement unless there was a clear indication, I asked CGS for details of the rationale for the denial and was told that only denied hospitals can get that information. Fortunately two loyal Monitor Monday listeners contacted me and provided details of their denials noting that their claims were denied for lack of a urinalysis or urine culture in the medical record. Then on February 10, perhaps in response to my inquires, CGS released “Cystourethroscopy with Inser-tion of Indwelling Ureteral Stent (CPT Code 52332): Documenting Urinalysis to Support Medical Necessity” with a detailed explanation of their documen-tation requirements to determine medical necessity. This included the requirement for “documentation of urinalysis (or urine culture or dipstick) results performed prior to the proce-dure, including treatments, if needed to treat identified infection.” In their narra -tive, CGS relates that patients who un-dergo endourologic manipulation with untreated bacteruria are more likely to have infectious complications, increas-ing the length of stay and cost of care. Apparently in an effort to confuse read-ers and equate medical necessity with risk assessment, CGS also posted as a reference an article by Nina Youngstrom in Report on Medicare Compliance that discusses the medical necessity require-ments for total joint replacement, which include an adequate trial of conservative non-operative management. While requesting documentation that the patient has urinary tract obstruction and therefore has medical necessity for a ureteral stent is appropriate, the pres-ence or absence of untreated bacturia has absolutely nothing to do with the medical necessity for the stent. If the patient requires an intervention, it is the duty of the physician and patient to as-sess the risks and benefits of proceeding with that medically necessary interven-tion and not the decision of the MAC. To apply this to joint replacement, if a Continued on page 2… March/April 2015, Vol. 5, No. 2 in this issue: MACs heading down a Slippery Slope from Medical Necessity to Quality of Care ................................. 1 Aetna Lawsuit against Texas Hospital Reveals Coding Confusion ............ 3 Post-hospital provider choice – how is your process? .................. 4 Home Health Certification – Is CMS making an about face on the face-to-face? ...................... 6 Everyone's a Critic except when it comes to Themselves. . . . . . . . . . . . . . . . . . 7 Strange Bedfellows join to defeat Common Enemy . . . . . . . . . . . . . . . . . . . . . . . 8 Medical Necessity 2015 – AccretivePAS presents to local Southern California Hospitals at St. Francis Medical Center .......... 10 401 N. Michigan Ave. Suite 2700 Chicago, IL 60611 tel: 312-931-3007 pas.info@accretivehealth.com accretivehealth.com /p>h2>Issue List/h2>h3 stylecolor:#000>a tabindex-1 href/march-april-2015-vol-5-no-2>March/April 2015/Vol. 5, No. 2/a>/h3>h3 stylecolor:#000>a tabindex-1 href/jan-feb-2015-vol-5-no-1>Jan/Feb 2015/Vol. 5, No. 1/a>/h3>h3 stylecolor:#000>a tabindex-1 href/nov-dec-2014-vol-4-no-8>Nov/Dec 2014, Vol. 4, No. 8/a>/h3>h3 stylecolor:#000>a tabindex-1 href/sept-oct-2014-vol-4-no-7>Sept/Oct 2014, Vol. 4, No. 7/a>/h3>h3 stylecolor:#000>a tabindex-1 href/special-edition-cms-administrative-agreement-offers-partial-payment-to-hospitals-to-ease-alj-log-jam>Special Edition-CMS Administrative Agreement offers partial payment to hospitals to ease ALJ log jam/a>/h3>h3 stylecolor:#000>a tabindex-1 href/aug-sept-2014-vol-4-no-6>Aug/Sept 2014, Vol. 4, No. 6/a>/h3>h3 stylecolor:#000>a tabindex-1 href/july-2014-vol-4-no-5>July 2014, Vol. 4, No. 5/a>/h3>h3 stylecolor:#000>a tabindex-1 href/may-june-2014-vol-4-no-4>May/June 2014, Vol. 4, No. 4/a>/h3>h3 stylecolor:#000>a tabindex-1 href/april-2014-vol-4-no-3>April 2014, Vol. 4, No. 3/a>/h3>h3 stylecolor:#000>a tabindex-1 href/march-2014-vol-4-no-2>March 2014, Vol. 4, No. 2/a>/h3>h3 stylecolor:#000>a tabindex-1 href/feb-2014-vol-4-no-1>Feb. 2014, Vol. 4, No. 1/a>/h3>h3 stylecolor:#000>a tabindex-1 href/dec-2013-vol-3-no-12>Dec. 2013, Vol. 3, No. 12/a>/h3>h3 stylecolor:#000>a tabindex-1 href/oct-nov-2013-vol-3-no-10>Oct./Nov. 2013, Vol. 3, No. 10/a>/h3>h3 stylecolor:#000>a tabindex-1 href/sept-oct-2013-vol-3-no-9>Sept./Oct. 2013, Vol. 3, No. 9/a>/h3>h3 stylecolor:#000>a tabindex-1 href/aug-sept-2013-vol-3-no-8>Aug./Sept. 2013, Vol. 3, No. 8/a>/h3>h3 stylecolor:#000>a tabindex-1 href/july-august-2013-vol-3-no-7>July/August 2013, Vol. 3, No. 7/a>/h3>h3 stylecolor:#000>a tabindex-1 href/june-july-2013-vol-3-no-6>June/July 2013, Vol. 3, No. 6/a>/h3>h3 stylecolor:#000>a tabindex-1 href/may-june-2013-vol-3-no-5>May/June 2013, Vol. 3, No. 5/a>/h3>h3 stylecolor:#000>a tabindex-1 href/april-may-2013-vol-3-no-4>April/May 2013, Vol. 3, No. 4/a>/h3>/main>footer>p stylecolor:#000>a stylecolor:#000 tabindex-1 href/march-april-2015-vol-5-no-2/page-2>Next/a>/p>br />a stylecolor:#000 tabindex-1 href/1/>Library/a>/footer> /div> iframe src# titlemenus idviewerFrame allowfullscreen>/iframe>div styledisplay:none>/div>script typeapplication/ld+json>{@context:https:\/\/schema.org,@type:PublicationIssue,name:AccretivePas Update March\/April 2015\/Vol. 5, No. 2,genre:Newsletter,dateCreated:2015-03-17,datePublished:2015-03-17,publisher:{@type:Organization,name:Plum Grove Printers,logo:{@type:ImageObject,url:http:\/\/img.coverstand.com\/27236\/logos\/logo.png,width:265,height:65}},url:http:\/\/accretivepas.plumgrovedigital.com\/march-april-2015-vol-5-no-2\/page-1?pp1,hasPart:,description:AccretivePAS\u00ae UpDate Hospital Industry Newsletter features the latest Medicare and Medicaid news, commentaries and results of audits and regulatory rulings, hospital industry news and case management reports and information. \r\n}/script>script typeapplication/ld+json>{@context:https:\/\/schema.org,@type:BreadcrumbList,itemListElement:{@type:ListItem,position:1,name:AccretivePas Update March\/April 2015\/Vol. 5, No. 2,item:http:\/\/accretivepas.plumgrovedigital.com\/march-april-2015-vol-5-no-2}}/script>/body>/html>
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