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.
CMS recently announced updates to the January 2025 Integrated Outpatient Code Editor, including new HCPCS codes and changes to a handful of status indicators.
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.
Review a cross-sectional study published in the Journal of the American Medical Association that revealed people experiencing homelessness were significantly less likely to receive inpatient systemic therapy or procedures despite having a higher prevalence of more aggressive cancers and longer lengths of stay.
The American Medical Association recently announced new codes, deletions, and revisions included in the 2025 CPT code set. Explore these notable updates to the code set.
Review a recent OIG audit which found that without strengthening program safeguards, CMS and its contractors may not be able to prevent or detect improper payments for short inpatient stays or recover overpayments for claims that do not comply with Medicare requirements.
According to a recent analysis, healthcare organizations are submitting more prior authorization requests to Medicare Advantage plans and more of those requests are being denied. Review the analysis’ findings to be more aware of prior authorization processes and CMS’ efforts to streamline them.
A cohort study published in the Journal of the American Medical Association found that the detection of incident stroke events is moderately accurate when using ICD-10-CM codes in Medicare claims and very accurate in ruling out non-stroke cases.
Patients who self-reported housing instability often didn’t have the correct ICD-10-CM codes documented in their record, according to a recent study. Review the results of the study and be more aware of the importance of properly documenting housing insecurity to ensure appropriate housing and medical services are delivered.
CMS released the FY 2025 IPPS final rule on August 1, which seeks to address key social determinants of health and strengthen emergency preparedness. This rule updates Medicare payments and policies for discharges from inpatient hospitals beginning October 1, 2024.
CMS’ proposed rule to revise the Medicare hospital Outpatient Prospective Payment System for calendar year 2025 has been released. Review some of the proposals that could directly impact your organization.
CMS’ fiscal year 2025 IPPS proposed rule and fact sheet proposes to upgrade certain codes describing social determinants of health (SDOH) to better capture the effect of housing instability on beneficiaries.
A study published in the Journal of the American Medical Association found that administration of piperacillin-tazobactam among patients with suspected sepsis was associated with a higher mortality rate and increased duration of organ dysfunction compared with cefepime administration.
CMS recently released an updated MLN fact sheet reminding providers about documentation requirements for requests from its Comprehensive Error Rate Testing (CERT) program.
CMS recently published the fiscal year 2025 ICD-10-PCS code set and guidelines. Although CMS made no changes to the guidelines, the update includes 371 new codes, 61 deleted codes, and three new tables.
CMS updated its July 2024 HCPCS Quarterly update file in May with a total of 70 new HCPCS codes, 11 discontinued codes, and 32 revised codes. All code changes will be implemented July 1.
A study published in the Journal of the American Medical Association found that four popular pretest risk assessment models for evaluating risk of hospital-acquired venous thromboembolism in inpatients did “not perform particularly well.”
