Review a retrospective cohort study published in the Journal of the American Medical Association that found new Alzheimer disease and related dementia diagnoses were more common after falls compared with other forms of traumatic injury.
Denials continue to be a pain point and significant challenge for every hospital across the nation, but Angelica Cage, MBA, BSN, RN, CCDS, CCS, CDIP , provides denial-proofed queries to show how establishing a diagnosis that is strongly supported by the available clinical evidence can reduce or eliminate clinical doubt with respect to the treated condition.
Certain diagnosis-related groups (DRGs) remain vulnerable to audits and denials, not only for DRG and clinical validation, but for medical necessity as well. Kim Conner, BSN, CCDS, CCDS-O , explores areas coding professionals can support when being proactive against these denials.
CMS implemented the FY 2025 IPPS final rule on October 1, which introduced several updates to New Technology Add-on Payment designations, directly affecting how inpatient services are coded and reimbursed. Follow Judith Kares, JD , as she reviews NTAP eligibility criteria and payment strategies, alternative pathways for approval, final new technologies, and application process changes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The majority of U.S. healthcare organizations struggle with denials and underpayments in all care settings, making it difficult to keep up with a meaningful manual appeals process. Learn how coding professionals can leverage technology to accurately capture and validate clinical data, ensuring proper coding and documentation while reducing the likelihood of denials.
With advice from three certified medical professionals, CDI specialists and healthcare providers can develop relationships that foster a culture of collaboration and continuous improvement in documentation and coding practices.
Q: A 65-year-old female has been on Effexor for major depressive disorder for three months and went to her healthcare provider due to tachycardia and palpitations along with mild muscle cramping. It was found that she had accidentally been taking double her prescribed dose due to misunderstanding the instructions. It is reported that she developed serotonin syndrome resulting from toxicity and was also diagnosed with mild hypertension (138/88) due to the serotonin syndrome. How would this encounter be reported in ICD-10-CM?
To comply with a summer court order, the FY 2025 Hospital Inpatient Prospective Payment System was revised to reduce payments for low wage hospitals. Review the updated policy to understand why these adjustments were implemented and what hospitals can expect going forward.
Coding professionals face challenges when the clinical meanings of words do not match the ICD-10-CM classification system, particularly for records related to matters of the heart. Follow Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC , as she applies critical thinking, knowledge of disease processes, and an understanding of ICD-10-CM codes to accurately report acute MI cases.
Lymphoma diagnosis codes received a robust overhaul with the release of the 2025 ICD-10-CM codes, reflecting advancements in understanding and classifying lymphoma. Accurate coding is crucial for reporting such nuances, and Nancy Reading, RN, BS, CPC, CPC-P, CPC-I , is here to update coders on the changes.
