Because third-degree burns are a severe injury that destroys the epidermis and dermis and may extend into the underlying subcutaneous tissue, accurate coding depends on clear documentation of burn depth, anatomical site, and total body surface area. Learn how to navigate the fundamentals of ICD-10-CM code selection and sequencing guidelines for third-degree burns, including how to prioritize burn severity and account for multiple injury sites. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Diagnosis-related group downgrades result from a mix of insufficient or incomplete documentation, coding errors, and diagnoses that lack clinical validation. When higher-acuity diagnoses designated as MCCs or CCs are removed, the case may be reassigned to a lower-paying DRG, resulting in a loss of revenue. Follow Nancy Reading, BS, CPC, CPC-P, CPC-I, as she discusses the challenges of denial reviews conducted by third-party payers and proactive strategies to prevent and manage denials.
Congenital heart defects, the most common type of birth defect, are among the most clinically significant anomalies in neonatal care. Bobbie Vannatter, MHA, RHIA, CCS, CDIP; Andrew Puckett, DNP, RN, NI-BC; and Vitality Shalumov, RN, BSN, CCDS, reviews selected neonatal congenital cardiac conditions and highlights key documentation considerations that influence coding and representation of severity.
Ensure your team is aware of the latest key updates to the Ambulatory Surgical Center (ASC) Payment System that went into effect on October 1, 2026, which includes changes to codes for surgical procedures, skin substitute products, and drugs, biologicals, and radiopharmaceuticals. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS is planning major reimbursement shifts for outpatient hospital services, according to the 2027 Outpatient Prospective Payment System (OPPS) proposed rule.
