On April 11, CMS released the fiscal year 2026 Inpatient Prospective Payment System proposed rule, which proposes a 2.4% payment increase for hospitals and several adjustments to quality reporting programs, including the Hospital Inpatient Quality Reporting Program.
Revenue integrity professionals have found that working with multiple departments is helpful in addressing denials. Discover how coders—alongside denial, clinical, and CDI professionals—can play a key role in this increased collaboration to manage and prevent denials.
With hundreds of ICD-10-CM codes available for the various forms and manifestations of osteoarthritis and rheumatoid arthritis, coding these conditions to their highest specificity can be surprisingly complex. Without a thorough understanding of their distinctions, and without clear documentation from providers, navigating this coding landscape can feel overwhelming. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Coding for joint replacement procedures requires extra attention to detail, particularly for device and qualifier characters and most importantly for partial replacements. Terry Tropin, MSHAI, RHIA, CCS-P , shows how these characters are very specific but give a clear picture of the procedure that was performed for a specific patient.
Anemia is a complex condition to manage clinically and document accurately, yet proper diagnosis, documentation, and coding are critical for ensuring appropriate patient care and reimbursement. Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP , explores the clinical aspects of anemia, including its definitions, types, causes, and management, while addressing the challenges in clinical documentation and coding.
AI is increasingly being integrated into the CDI industry and as these tools evolve, their capabilities will naturally extend into adjacent fields like medical coding. Although AI may not be an entirely welcome change, Sarah Matacale, BSN, RN, CCS, CCDS , highlights practical ways CDI professionals and even coders can adapt to and benefit from these new tools.
Even though Congress didn’t fully unleash telehealth services, instead extending the long-running telehealth waivers through September, making your telehealth services a permanent offering can improve your practice’s financial health.
Our experts answer questions about the standard of care, reporting reduced services, and problems addressed during evaluation and management office visit.
Our experts answer questions on NICU coding, ICD-10-CM coding for kidney transplants with kidney failure or other complications, and the acceptance of systemwide clinical definitions on queries.
Accurate medical coding for dermatological procedures is essential for proper payment and compliance. This article provides a detailed overview of coding guidelines for excisions and repairs, ensuring that healthcare professionals correctly report these procedures.