CMS recently issued a proposed rule for 2026 that includes provisions aimed at limiting Medicare Advantage in-network cost-sharing for behavioral health services to be no greater than the traditional Medicare rates. Find out what the proposed behavioral health cost-sharing standards are in the proposed rule.
Q: What were the AMA’s goals for revising evaluation and management (E/M) services that were implemented starting in January 2021 and continued in January 2023?
In a recent release published by the WHO and CDC, new estimates revealed cases of measles are surging worldwide due to inadequate immunization coverage. Coders should explore the implications of this outbreak, as they play a critical role in supporting healthcare systems manage vaccination efforts and protect public health.
Q: A frail 74-year-old female presents with severe shortness of breath and hypoxia. She has a known history of smoking two or more packs per day for the past 40-50 years and has a complex history of chronic obstructive emphysema, centrilobular emphysema, bronchiectasis, and pulmonary hypertension. Her current hospitalization is due to MRSA pneumonia with planned discharge to home health for continued care. How would this diagnostic note be reported in ICD-10-CM?
Because substance use, abuse, and dependence are critical areas within healthcare that impact CDI and coding, Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP , provides readers with an in-depth analysis of these conditions and emphasizes their clinical, diagnostic, and coding implications.
Health information management occupies a pinnacle position in the revenue cycle, and although the span of coding’s influence throughout a healthcare organization is very broad, its effects can also be found in numerous revenue cycle spokes, including preregistration and scheduling, coverage approvals, and case management. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Marc Hartstein, MA , brings together all the major highlights of Medicare’s newest Inpatient Prospective Payment System, allowing coders to stay informed about key updates and navigate the changes throughout the year.
CMS finalized its proposal to relax restrictions on complexity of care add-on HCPCS code G2211. The changes come in response to stakeholder concerns that the current CMS policy is disruptive to the way providers normally treat patients. This article covers how to prepare for this update.
Acute respiratory distress syndrome presents a significant clinical challenge due to its rapid onset, high mortality rate, and complex management. Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP , delves into the comprehensive aspects of ARDS to show how coders, alongside healthcare providers and CDI specialists, play an essential role in reporting the complete picture of the condition.
