Addressing the reliability of documentation, coding, and clinical reasoning underlying PSI flags is not simply a clinical safety imperative; it is a strategic business imperative. Priscilla Marlar, MHA, CSSBB, CPHQ, and John W. Cromwell, MD, suggest that achieving high reliability in quality data integrity starts with understanding the nuances of clinical documentation language and how those nuances are translated by CDI and coding teams into hospital billing codes.
Due to all of the possible scenarios that come with a pregnancy, the reporting of ICD-10-CM diagnosis codes must reveal the specific risks patients have so that procedures, services, and treatments can all be supported. Follow Shelley C. Safian, PhD, MAOM/HIM/HI, RHIA, CCS-P, COC, CPC-I, as she outlines best practices for specifically reporting high-risk pregnancies.
CMS released the fiscal year 2026 ICD-10-CM files for use for discharges and patient encounters occurring from April 1 through September 30, 2026. Take time to review the updates. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
A neonatal intensive care unit offers very specialized medical services and treatments to premature and critically ill neonates (i.e., babies 28 days old or younger). Review which ICD-10-CM and CPT codes may be used for providers assisting in this type of care.
A study recently published in JAMA Network Open examined trends in outpatient mental health care among Medicare fee-for-service beneficiaries before, during, and after the COVID-19 pandemic.
Part B providers are facing a radically different reimbursement landscape in 2026. In the 2026 Medicare Physician Fee Schedule final rule, CMS moved ahead with many of the changes it floated in the proposed rule, including fundamental changes to how the conversion factor is calculated, relative value unit valuation, payments for skin substitutes, and more.
Correctly coding an aneurysm depends on the type and location, the specific vessels involved, and the presence or absence of associated complications such as ruptures. Each of these elements directly impacts code assignment, making detailed clinical documentation essential to ensure the conditions are accurately represented in the medical record. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Coding for spinal fusions can be very complex, with many different devices and approach options as well as the procedure requiring more than one code. Terry Tropin, MSHAI, RHIA, CCS-P, walks through the New Technology section of the ICD-10-PCS along with other less common sections to find where appropriate spinal fusion codes can be located.
CMS announced it is adding 80 new procedure codes to the fiscal year 2026 ICD-10-PCS code set, available for discharges occurring from April 1 through September 30, 2026. This is in addition to the 156 new codes that went into effect on October 1, 2025. Only two codes will be deleted.
