If denials are not going anywhere anytime soon, increasing at an alarming rate, and causing organizations to close, how do hospitals ameliorate this issue? Hospitals, including coders, can work to stem it by understanding the different types of denials, the problems they pose, and the tactics required to fight them.
Q: A female patient previously had an inpatient stay due to severe enteritis secondary to the use of Keytruda for colon cancer that she was diagnosed with six months earlier. While she has had positive results to the medication, she presented to the ER last week due to severe abdominal bloating and cramping with diarrhea and stools with large amounts of mucous. She was dehydrated and hypokalemic upon inpatient admission and has a history of depression. Her discharge note indicates that her potassium levels and dehydration are normalized. How would this encounter be reported in ICD-10-CM?
Patients diagnosed with a malignant neoplasm, commonly known as cancer, are now living longer due to better treatments. In 2025, there are 47 new ICD-10-CM codes to be used to report lymphoma in remission. This article broadly reviews those new codes.
Coders should use particular care when selecting diagnosis codes, always selecting the most specific code possible, based on the clinician’s documentation. This article covers diagnosis coding guidelines to help avoid using vague or non-specific diagnosis codes that will likely result in denials. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Enhanced care management codes for advanced primary care management services in the physician fee schedule proposed rule have been cleared. This article discusses the terms billing providers and their teams must meet when providing these services.
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?
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.
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.
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.
