Revenue integrity professionals have found that working with multiple departments is helpful in addressing denials. Discover how coders—alongside denial, clinical, and CDI professionals—can play a key role in this increased collaboration to manage and prevent denials.
Coding for joint replacement procedures requires extra attention to detail, particularly for device and qualifier characters and most importantly for partial replacements. Terry Tropin, MSHAI, RHIA, CCS-P , shows how these characters are very specific but give a clear picture of the procedure that was performed for a specific patient.
With hundreds of ICD-10-CM codes available for the various forms and manifestations of osteoarthritis and rheumatoid arthritis, coding these conditions to their highest specificity can be surprisingly complex. Without a thorough understanding of their distinctions, and without clear documentation from providers, navigating this coding landscape can feel overwhelming. Note : To access this free article, make sure you first register if you do not have a paid subscription.
On April 11, CMS released the fiscal year 2026 Inpatient Prospective Payment System proposed rule, which proposes a 2.4% payment increase for hospitals and several adjustments to quality reporting programs, including the Hospital Inpatient Quality Reporting Program.
CMS recently proposed hundreds of ICD-10-CM code changes in the 2026 Hospital Inpatient Prospective Payment System proposed rule, including 487 new codes, 38 revised code descriptions, and 28 invalidated codes. The rule also proposes 14 new ICD-10-PCS codes.
The first quarter publication of Coding Clinic added clarifications for some of the new codes from fiscal year 2025 and a question-and-answer section that discussed complicated coding issues. Terry Tropin, MSHAI, RHIA, CCS-P , reviews the advice and guidelines for ICD-10-PCS codes.
Misidentifying seizures and convulsions can easily lead to incorrect code assignment as each seizure subtype carries its own specific ICD-10-CM codes. Coding these conditions can be simplified, however, when coders have a strong grasp of the clinical and coding classifications for seizures. Note : To access this free article, make sure you first register if you do not have a paid subscription.
Preventing revenue leakage is one of the core goals of a revenue integrity program, but with numerous sources of potential leaks, meeting this goal is often easier said than done. Michele Bear, DBA, MBA, CHRI, CRCR, CHC, CPC , focuses on key elements of successful revenue integrity programs that can prove to be effective and proactive.
While the use of artificial intelligence has begun to change how healthcare organizations process data, large language models have not yet reached the level of sophistication to meet the demands of medical coding, according to an op-ed published by Forbes.
Asthma is a common lung disorder in which inflammation causes the bronchi to swell and narrow the airways, leading to airflow obstruction. Discover the coding considerations surrounding this disorder to ensure you’re documenting it correctly. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
The Affordable Care Act provides preventive and early diagnosis healthcare services for free to anyone with a health insurance policy. This article provides coding specialists with guidance to ensure they’re documenting these services correctly so that providers are compensated properly.
CMS recently issued a bulletin highlighting new Medicare documentation guidelines and providing additional resources for documentation compliance. Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CDIP, CCS , outlines the key takeaways from this latest guidance and emphasizes how health information, CDI, and coding teams play a role in compliant documentation.
Review a study based on ICD-10-CM data from the National Vital Statistics System that shows a decline in U.S. drug overdose deaths from 32.6 deaths per 100,000 of the country’s standard population in 2022 to 31.3 deaths per 100,000 in 2023.
Forensic medical coding is a specialized field that combines the precision of medical coding with the complexities of the legal system. Understanding the skills needed and the types of cases in which medical coding is essential becomes crucial to those looking to enter the field. Note : To access this free article, make sure you first register if you do not have a paid subscription.
With 50 new ICD-10-PCS codes implemented on April 1, Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I , thoroughly reviews the codes to help inpatient coders accurately apply the updates.
