* OIG Targets Hospitals in Its 2008 Work Plan

* Question of the Day: Emergency Dept. Injection/Infusion Coding Getting Stricter

* Know Your Doctor’s Dictionary

Last week, the OIG released an audit report showing that some hospitals aren’t billing accurately for ESRD-related lab services.

The OIG audited a Boston hospital to determine whether lab tests administered to ESRD (end stage renal disease) patients were billed accurately, and found that the hospital collected $61,000 more than they should have for these services.

“Specifically,” the audit report states, “the Hospital incorrectly billed for (1) hematology laboratory services included in the composite rate, (2) automated multi-channel chemistry tests that did not meet specific reimbursement requirements, and (3) ferritin tests performed beyond the allowable frequency without medical justification.”

The OIG asked the hospital to refund the $61,000 and to strengthen its internal policies to ensure that the hospital firm up its compliance regs.

To read the full audit report, visit http://www.oig.hhs.gov/oas/reports/region1/10700506.pdf.

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Question: My practice started reporting the hydration, injection and infusion CPT codes in 2006. However, I was told that there was new language in the 2008 CPT book that may change our ability to report these codes on behalf of physicians working in the ED. What's the story with injection/infusion/hydration coding in 2008?

Answer: Unfortunately, you will likely have to shelve the injection, infusion and hydration codes for services your ED physician provides. CPT introduced new language in this code section for 2008.

Then: In 2006, CPT rewrote the hydration, injection and infusion code set. The 90760-90779 code set included the following directions, which left room for ED physicians to report the codes:

* "Physician work related to hydration, injection, and infusion services predominantly involves affirmation of treatment plan and direct supervision of staff."

* "Typically such infusions require little special handling to prepare or dispose of, and staff that administer these do not typically require advanced practice training.

* After initial set-up, infusion typically entails little patient risk and thus little monitoring."

* "These services typically require direct physician supervision for any or all purposes of patient assessment, provision of consent, safety oversight, and intraservice supervision of staff."

Now: CPT 2008 adds additional language to the directions for this code set -- most notably this directive: "These codes are not intended to be reported by the physician in the facility setting."

Impact: Based on the new 2008 CPT language, you will no longer be able to report these codes on the professional side in the ED setting.

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In each issue of your Hospital Compliance Wire, you"ll get a new list of medical acronyms. Today we're following up on our last issue and we're now moving on to the letter "D." Download the entire dictionary FREE at www.healthcarepubinfo.com/AcronymDictionary2007v2.pdf

DB&C -- deep breathing and coughing

D/C -- discharge or discontinue

D&C -- dilation and curettage

DDH -- developmental dysplasia of hip 

DE -- dose equivalent

Def. -- deficient or deficiency

Del -- delivery

Dep. -- dependent

DES -- diethyl stilbestrol

DEXA -- dual energy x-ray absorptiometry

DIC--disseminated intravascular coagulation

DIEP -- deep inferior epigastric perforator flap

DIF -- direct immunofluorescence

DIP -- distal interphalangeal

DISH -- diffuse idiopathic skeletal hyperostosis

DJD -- degenerative joint disease

DKA -- diabetic ketoacidosis

DM -- diabetes mellitus

DME -- durable medical equipment

DMPA -- depot medroxyprogesterone acetate (Depo Provera)

DNR -- do not resuscitate

DOA -- dead on arrival

DOB -- date of birth

DOS -- date of service

DR -- dorsal root

DRUJ -- distal radio-ulnar joint

Dsg -- dressing

DSMT -- diabetes self-management training

d/t -- due to

DT -- tetanus and diphtheria toxoids

DTaP -- diphtheria, tetanus toxoids, pertussis vaccine

DUB -- dysfunctional uterine bleeding

DVT -- deep vein thrombosis

Dx -- diagnosis

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