The Centers for Medicare & Medicaid Services has pulled information on health-related social needs (HRSN), a subset of broader social determinants of health factors, for state Medicaid and the Children’s Health Insurance Program, potentially making it harder for services that address HRSNs to be covered by these affected programs.
Review a study based on ICD-10-CM data from the National Vital Statistics System that shows a decline in U.S. maternal mortality rates from 22.3 deaths per 100,000 live births in 2022 to a rate of 18.6 deaths in 2023.
A recent report from the Brown University School of Public Health compared the average commercial price for low-complexity, low-intensity medical care in New York hospital outpatient departments to the same care provided in non-hospital settings, such as physician offices and ambulatory surgery centers.
Review a study funded by the National Institutes of Health that has found adults who were hospitalized for a severe infection, such as respiratory infections or sepsis, were twice as likely to develop heart failure years later.
A recent study published in BMC Public Health, found that patients in Colorado diagnosed with long COVID increasingly sought care from outpatient and specialist visits over hospital and emergency department visits.
Review a study published in a recent edition of Health Affairs that discovered which type of hospitals are not evaluating their AI tools internally for accuracy or potential biases and explored whether models developed in-house or by external developers were supported more by local evaluations.
CMS recently published an update to the fiscal year 2025 ICD-10-PCS code set, available for discharges occurring from April 1 through September 30, 2025. Although CMS made no changes to the guidelines, the update includes 50 new codes, 12 deleted codes, and two new tables.
The worldwide outpatient clinic market is projected to grow considerably in the next few years. Learn what key factors are driving the increase in demand for outpatient services.
After the Medicare Payment Advisory Commission reviewed draft recommendations for 2026 payment updates, which included increases only for hospital inpatient and outpatient services, the commission was urged by the American Hospital Association to revise the recommendations. Learn what AHA is recommending instead before the commission meets again tomorrow morning.
A study recently published in JAMA Network Open examined the effects of outpatient rehabilitation programs for patients with post-COVID-19 condition. Find out how the patients benefited from these programs.
Black Book Research recently surveyed more than 4,000 health information management professionals about their concerns for the new year. Find out what issues are at the top of their minds for 2025.
Following questions from Congress on what steps the government should take to eliminate remaining barriers in accessing addiction treatment, the American Hospital Association noted two out of eight policy and regulatory barriers that currently impact inpatient facilities. Learn what the consequences could be if these barriers were addressed.
CMS recently issued a proposed rule for 2026 that includes provisions aimed at limiting Medicare Advantage in-network cost-sharing for behavioral health services to be no greater than the traditional Medicare rates. Find out what the proposed behavioral health cost-sharing standards are in the proposed rule.
In a recent release published by the WHO and CDC, new estimates revealed cases of measles are surging worldwide due to inadequate immunization coverage. Coders should explore the implications of this outbreak, as they play a critical role in supporting healthcare systems manage vaccination efforts and protect public health.
A recent OIG audit estimates that Medicare improperly paid $190.1 million for outpatient services provided to hospice enrollees over five years. Learn how the audit was performed and why the payments were improperly made.
A new separate payment is available under the FY 2025 IPPS for small, independent hospitals who choose to establish and maintain access to buffer stocks of essential medicines. Learn why this initiative was created and the potential impacts on future drug shortages.
Review a recent OIG audit which found that Medicare payments for inpatient claims assigned with MS-DRGs 207 and 870 did not fully comply with Medicare requirements, resulting in $79.4 million being improperly paid to hospitals.
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.
