CMS' Bundled Payments for Care Improvement Advanced model will qualify as an Advanced Alternative Payment Model under the Quality Payment Program and include outpatient episodes.
The advancement of accurate and compliant coding efforts brings unique challenges. As benevolent as a health information management (HIM) department’s mission may seem to be, for many facilities, the focus of physician queries continues to be “optimizing” information in the medical record to increase reimbursement.
A recent report released by the Centers for Disease Control and Prevention revealed that almost 70% of Americans are considered overweight or obese. This epidemic costs American healthcare systems approximately $190 billion per year in treatment of weight-related conditions.
Congestive heart failure (CHF) is a commonly diagnosed condition where the ventricles or the lower chambers of the heart do not work effectively. The heart serves as a pump to get blood in and then out of the heart to circulate to the rest of the body. When any type of pump doesn’t work efficiently, backups can occur.
Medicare fee-for-service claims had a 90.5% accuracy rate and a 9.5% improper payment rate for all claims submitted between July 1, 2015- June 30, 2016, according to a recent CMS Comprehensive Error Rate Testing report.
New ICD-10-CM/PCS codes provide additional specificity to describe the condition of and care afforded to a given patient. This article takes a closer look at these code updates as well as guidelines for reporting codes under new payment models.
Updates to the 2018 CPT Manual particularly effect coding for cardiovascular and laboratory procedures. Stay-up-to-date with these changes and take time to understand complex procedures to prevent interruptions to claims processing. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Approximately 2%-3% of children between the ages of 6 and 12, and 6%-8% of adolescents in the U.S. may have serious depression. Debbie Jones, CPC, CCA details common symptoms of anxiety and depression in adolescence and provides advice for diagnostic coding of these conditions.
Q: What should we report if you have a compression dressing that was applied to the thigh, in addition to the lower leg, since CPT code 29582 (multi-level compression bandage application, thigh to foot) was deleted for 2018?
Lynelle A. Clausen, RN, BSN, writes about the struggles she faces as a CDI specialist when dealing with vague documentation, lack of criteria, and the reporting of malnutrition.
Q: If the attending physician documented, “likely mixed cardiogenic and septic shock,” can I assign ICD-10-CM codes R57.0 (cardiogenic shock) and R65.21 (severe sepsis with septic shock)?
On January 9, CMS announced the launch of Bundled Payments for Care Improvement Advanced from the agency’s Center for Medicare and Medicaid Innovation.
Surprisingly, thyroid disease is more common than diabetes or heart disease, with an estimated 20 million Americans having some form of the disease. In this article, Yvette M. DeVay, MHA, CPC, CPMA, CIC, CPC-I gives readers a background on thyroid cancer and reviews ICD-10-CM/PCS coding for the disease.
With yearly ICD-10 code and guideline updates to the respiratory system, it’s important for coders to stay abreast of changes to ensure documentation and coding integrity. This article takes a closer look at the ICD-10-CM code updates as well as recent Coding Clinic guidance on the respiratory system. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In perusing the United States Department of Health and Human Services Office of Inspector General’s (OIG) Work Plan , there are many clinical issues that we in ICD-10-CM/PCS coding compliance must address.
Complying with healthcare regulations within a coding department or physician practice involves promoting a positive attitude toward activities such as self-monitoring and staying up-to-date with healthcare regulations. Follow these steps to adhere to sound business ethics and set expectations for behavior across an organization. Note: To access this free article, make sure you first register here if you do not have a paid subscription.