An upcoming audit reviewing Medicare inpatient hospital billing for sepsis underscores the critical importance of accurate coding and clinical validation. With guidance from Leigh Poland, RHIA, CCS, CDIP, CIC , coders can help prevent costly coding errors, reduce the risk of audits, and ensure hospitals are appropriately reimbursed for the care they provide. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Trey La Charité, MD, FACP, SFHM, CCS, CCDS , invites a deeper understanding for diagnosing and documenting acute renal failure and any other related diagnoses—before exploring the plethora of denial strategies medical staff may face. Not to worry as there are opportunities for successful appeals!
A new separate payment is available under the FY 2025 IPPS for small, independent hospitals who choose to establish and maintain access to buffer stocks of essential medicines. Learn why this initiative was created and the potential impacts on future drug shortages.
The concept of social determinants of health (SDOH) has transformed significantly, advancing from increased awareness to data integration and the development of tools and frameworks. This article explores the importance of integrating SDOH into the healthcare framework and the coding process, as well as best practices for leveraging this data to inform health interventions.
With CMS publishing annual updated versions of its Medicare National Correct Coding Initiative (NCCI) Policy Manual, as well as quarterly updates to the individual NCCI edit files, it is often hard for facilities to keep up with the changes. This article details the latest updates, as well as provides insights on implementing NCCI-associated modifiers and tips for preventing and overriding common edits.
CMS implemented modifier -FS (Split [or shared] E/M visit) as part of a major revision to its rules for split/shared services on January 1, 2022. This article provides tips for using modifier -FS from top reporters as it approaches its third year of active status. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: Patient presents with a chief complaint of persistent cough for 10 days with occasional mucus. She has a history of chronic asthmatic bronchitis for many years; is quite frail, reporting decline in energy and activity tolerance; was a smoker until about five years ago; and suffers chronic smokers’ cough and centrilobular emphysema. Past medical history includes heart failure, hypertension, and pulmonary hypertension. How would this diagnostic note be reported in ICD-10-CM?
Coding professionals are critical to the compliance initiatives of any healthcare organization, and the application of codes to a claim ignites the compliance ember. Discover how key initiatives not only ensure coders act ethically and responsibly but also enhance the accuracy of coding. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
