ABSTRACT
Case Study 4.1: Hot and Cold Packs Case Study 4.2: Routine Vitamin Injection Case Study 4.3: Anesthesiology and Patient-Controlled Analgesia Case Study 4.4. Spleen Injury from Accident Case Study 4.5: Clinic Lesion Removal Case Study 4.6: Hospitalist Providing Post-Operative Care Case Study 4.7: Laceration Repair at a Clinic Case Study 4.8: Laceration Repair at Emergency Department Case Study 4.9: Post-Operative Transfer of Care Case Study 4.10: Hospitalist Providing In-Hospital Post-Operative Care Case Study 4.11: Repeat Laceration Repair Case Study 4.12: Applying the Complications Rule for Payment Case Study 4.13: Mohs Micrographic Surgery Case Study 4.14: Arthroscopic Procedure Converted to Open Procedure Case Study 4.15: Bilateral Laceration Repairs Case Study 4.16: Multiple CT Services of the Spine Case Study 4.17: Colonoscopy Case Study 4.18: Nurse Practitioner at the Acme Medical Clinic Case Study 4.19: Physician’s Assistant at Freestanding Clinic Case Study 4.20: Nurse Practitioner Hired by ER Physicians Case Study 4.21: Surgery Using an Assistant at Surgery Case Study 4.22: Pilonidal Cyst Surgery at an ASC Case Study 4.23: Infusion Services with Two Access Sites Case Study 4.24: Two Lacerations Case Study 4.25: Interventional Cardiovascular Catheterization Services Case Study 4.26: Fracture and Splinting Care in the ED Case Study 4.27: CMS Drops Consultation Codes Case Study 4.28: Consultation Codes Primary with Medicare Secondary
Case Study 4.29: Medicare Secondary at Provider-Based Clinic Case Study 4.30: ER Professional Charges Case Study 4.31: Self-Pay Patients
Case Study 5.1: Anesthesiology Payment Case Study 5.2: MDA Supervising CRNAs Case Study 5.3: Cancelled Surgery Case Study 5.4: Statistical Study of MAC Case Study 5.5: Using MAC for Conscious Sedation Procedure Case Study 5.6: Rural Ambulance Run Case Study 5.7: Ambulance to and from SNF Case Study 5.8: Helicopter Located at Apex Medical Center Case Study 5.9: Ambulance as a Taxi Case Study 5.10: Two Patients Transported from Accident Scene Case Study 5.11: Dead at the Scene Case Study 5.12: Computerized Axial Tomographic Scanner Broken Case Study 5.13: Missing Laboratory Modifiers Case Study 5.14: Coumadin Clinic Activities Case Study 5.15: Souped-Up Wheelchair Case Study 5.16: Continuous Positive Airway Pressure Nasal Cushion Replacement
Case Study 6.1: Laboratory Fee Schedule Case Study 6.2: DME Payment Case Study 6.3: Setting Clinic Charges Case Study 6.4: Rural Charges versus UCR Case Study 6.5: Out-of-Network Services Case Study 6.6: Multiple Lacerations Case Study 6.7: Upper Gastrointestinal Endoscopy
