Livanta is sending documentation requests for short stay inpatient audits.
Livanta, the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) auditor, has started sending out documentation requests for short stay inpatient audits, according to an online forum for utilization review professionals.
As part of the process, Livanta will select 30 inpatient admissions of Medicare beneficiaries whose inpatient length of stay (LOS) was either zero or one day within the prior three months from selected hospitals, according to Dr Ronald Hirsch, who is the vice president of R1 RCM.
“You will have 30 days to submit the records to Livanta,” said Hirsch in an email to RACmonitor. “Livanta will fax the ADR to the number on the Memorandum of Agreement (MOA) with the hospital. If there is no fax number, they will mail it via USPS.”
Hirsch urged cautioned in reading the ADR for instructions to submit the records properly, adding “check your MOA to ensure the information is up to date.”
“The use of occurrence span code 72 is commonly used to indicate that the patient has passed two necessary midnights in the hospital but less than two as inpatient, but the presence of this code will not exempt the admission from audit,” said Hirsch. “Do not be alarmed by inclusion of these (because) if the care was necessary and passed two midnights, they should not be denied.”
Hirsch explained that Livanta will offer a discussion period to discuss any potential denials and urged every facility to take advantage of this discussion period to provide new information and understand the rationale for the denial.
Programming Note: Listen to Dr. Ronald Hirsch every Monday on Monitor Mondays, 10 Eastern.
As we know, artificial intelligence (AI) is in the spotlight these days. It is being adopted in almost every sector of the economy. It is
Our first topic today is local coverage determinations (LCDs) and variation. I have written in the past about national and local coverage determinations, and I
Please log in to your account to comment on this article.
Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.
Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.
Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.
Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.
Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.
HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2024 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Kay Piper reviews the guidance and updates coders on information in the AHA’s third quarter 2024 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Copyright © 2024 ICD10monitor. Powered by MedLearn Media.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’ is just $99 for a limited time! Use code WorldHealth24 at checkout.
