U.S. government civil healthcare fraud settlements exceeded $1.6 billion in 2022, according to the recently released 2022 Health Care Fraud and Abuse Control Program Annual Report.
Spinal surgery for hospital coders can be very challenging if they do not know the rules for assigning the correct ICD-10-PCS codes. Nancy Reading, RN, CPC, CPC-P , reviews spinal anatomy and surgical approaches, and offers tips on how to select the most appropriate characters in ICD-10-PCS.
The healthcare setting can feel like a courtroom in the denials and appeals arena. By assessing the effort that goes into an appeal and the difference that comes out of them, coders and CDI specialists may find that the chasm between clarifying a patient record and defending it isn’t as wide as they think.
Part B physicians will have to prepare for a net 3.4% payment decrease across services in 2024, according to the 2024 Medicare Physician Fee Schedule final rule, which covers numerous operational areas for medical groups, including new coverage opportunities and billing revisions to coding and compliance updates.
After years of working to engage providers and get them on board with CDI efforts, every seasoned CDI professional knows there’s no one-size-fits-all solution.
The 2024 OPPS final rule details changes to price transparency compliance, reimbursement changes and, updates to numerous other hospital programs. Additionally, CMS is moving forward with its proposals to address unlawful payment reductions to 340B drug reimbursement.
The National Correct Coding Initiative released the 2024 NCCI Policy Manual in early December, which will be effective January 1. This article covers the changes—both big and small.
Our experts answer questions about finding the right assessment tool for reporting social determinants of health, choosing CPT modifiers for same-day services, and more.
Anemia describes a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient. Review the types of anemia, diagnostic criteria, treatment, and ICD-10-CM coding.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a broad federal law that establishes the basic privacy and security protections that coders are required to follow.
