Keeping up with commercial payer requirements can stump any revenue integrity department, and commercial payer audits can be an especially tough puzzle to solve.
Prevention of the flu is important as this illness can lead to hospitalization and even death. The CDC reports the hospitalization rate due to the flu is 2.7 per every 100,000 persons, and there is a 4.8% mortality rate due to influenza and pneumonia.
HCPro’s 2019 coding productivity survey showed that coding productivity held steady for 2019, but facilities continue to struggle with miscommunications between coding and CDI staff and unanswered physician queries.
If you aren’t yet confused by the site-neutral payment policy changes prompted by CMS apparently ignoring both Congressional intent and the American Hospital Association (AHA) and other impacted hospitals filing suit, you are likely to become so now.
Due to the frequency of diagnoses and treatments for breast cancer, it’s more important than ever for inpatient coders to make sure they are reporting these diagnoses and procedures with the utmost accuracy.
HIM directors’ and managers’ salaries made gains in some areas, but others may be falling behind, according to respondents of HCPro’s 2019 HIM director and manager salary survey.
As the cost of healthcare continues to skyrocket, payers are looking for ways to save and want to make sure that claims reflect correct information and that the care provided was clinically justified.
One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.
James S. Kennedy, MD, CCS, CDIP, CCDS , reviews updated policies in the 2020 Medicare Physician Fee Schedule final rule that will affect ICD-10-CM risk-adjustment reporting and documentation for facilities.
Although the dollar figures aren’t big, the Office of Inspector General’s (OIG) report on faulty chronic care management (CCM) billing should be concerning for physician practices billing these codes.
JustCoding’s sister publication, HIM Briefings, conducted a benchmarking survey to shed light on edit and denial management processes across the industry. Review findings from the survey to see how your organization compares to those across the industry.
In the 2020 Medicare Physician Fee Schedule (MPFS) final rule, CMS put a stamp of approval on its previous proposals to overhaul how medical practices will report office and outpatient E/M services in 2021.
CPT reporting for surgical heart procedures requires an in-depth understanding of cardiovascular anatomy and terminology. This article reviews CPT reporting for procedures involving cardiac pacemakers and implantable cardioverter-defibrillators based on key details in provider documentation.
Let’s take a deep dive into the recently released coding guidance and documentation tips for these illnesses. Note that since vaping-related guidance and statistics are ever changing, this information is up to date as of October 2019.
Very few diagnoses have caused as much gnashing of teeth as sepsis has for inpatient coders and providers alike. Recently, the Centers for Disease Control and Prevention (CDC) has weighed in on the matter and is proposing coding changes , which, if adopted, will go into effect October 2020.
According to ACDIS’ recent CDI Week Industry Survey , which included an extended section on CDI staffing practices, only 37% of respondents said they had HIM/coding backgrounds represented in their CDI departments.
Review finalized changes to relative value units for office visits, new HCPCS codes for chronic care management and opioid treatment services, and future updates to the E/M reporting guidelines.
While many familiar ideas are often discussed—newsletters, tip sheets, organizational clinical definitions, and the like—not every physician responds the same way to the same educational techniques. Here’s what the CDI community had to say regarding this issue.
