Hospitals and health systems have recently seen some of the worst margins since the start of the COVID-19 pandemic, according to Kaufman Hall’s National Hospital Flash report .
A rise in patient acuity during the COVID-19 pandemic has contributed to significant growth in hospital costs, according to a recent report by the American Hospital Association (AHA).
A recent audit conducted by the Office of Inspector General (OIG) found that Cariten Health Plan Inc. in Knoxville, Tennessee, received at least $9.2 million in net overpayments from 2016 to 2017 for incorrectly submitting selected high-risk diagnosis codes.
CMS released the fiscal year (FY) 2023 IPPS final rule on August 1, increasing hospital payment rates by 4.3% and establishing three health equity-focused measures in hospital quality programs.
Q: When would you report an ICD-10-CM code from category I22 (subsequent ST elevation and non-ST elevation myocardial infarction [MI]) with a code from I21 (acute MI)?
Twenty-five percent of hospitalized Medicare patients experience patient harm, and 43% of those harm events could have been prevented, according to a recent Office of Inspector General (OIG) report.
Peoples Health Network received an estimated $3.3 million in overpayments between 2015 and 2016 for incorrectly billing ICD-10-CM codes from high-risk groups, according to a recent audit by the Office of Inspector General (OIG).
The Centers for Disease Control and Prevention recently released the fiscal year (FY) 2023 ICD-10-CM code set and ICD-10-CM Official Guidelines for Coding and Reporting , introducing new codes and guidance for reporting dementia, head injuries, and long-term drug therapy.
CMS recently released the fiscal year (FY) 2023 ICD-10-PCS code set and ICD-10-PCS Official Guidelines for Coding and Reporting . The ICD-10-PCS update includes several new codes for Destruction and Occlusion, and a new guideline for Detachment procedures of the extremities.
The establishment of mandatory sepsis protocols at all hospitals in New York state is estimated to have saved more than 16,000 lives between 2015 and 2019, according to End Sepsis.
Hospitalists coded a significantly higher proportion of Medicare beneficiaries as high severity compared to non-hospitalists, according to a study published in the Journal of the American Medical Association Health Forum .
CMS released the fiscal year (FY) 2023 IPPS proposed rule on April 18, with proposals for the annual ICD-10-CM/PCS code update and increases to hospital payment rates. The rule also introduces new quality measures aimed at advancing health equity and improving maternal health outcomes.
A recent audit conducted by the Office of Inspector General (OIG) projected that hospitals received $47.8 million in net overpayments from January 2018 through July 2019 for Medicare Part A claims that did not meet national requirements or contractor specifications for bariatric surgery.
CMS recently released three ICD-10-PCS codes, effective April 1, for the administration of fostamatinib (Tavalisse®)—an oral spleen tyrosine kinase inhibitor used to treat adults with low platelet count due to chronic immune thrombocytopenia.
A recent audit conducted by the Office of Inspector General (OIG) found that Tufts Health Plan Inc. (Tufts) received at least $3.7 million of net overpayments from 2015 to 2016 for incorrectly submitting selected high-risk diagnosis codes.
The Office of the Inspector General (OIG) recently announced it will conduct statewide reviews to determine whether hospitals complied with Medicaid billing requirements when assigning severe malnutrition diagnosis codes to inpatient hospital claims.
CMS recently released two ICD-10-PCS codes, effective April 1, to describe the introduction or infusion of therapeutics, including vaccines for COVID-19 treatment.
The Centers for Disease Control and Prevention (CDC) recently released multiple addenda with new tabular and index instructions and updates to the ICD-10-CM Official Guidelines for Coding and Reporting to complement the updated ICD-10-CM code set to become effective April 1.
The fall 2021 Leapfrog Hospital Safety Grade report has been released, assigning grades to 2,901 hospitals. The grades come from hospitals’ performance on over 30 evidence-based measures of patient safety. For the first time, a new grading factor for post-operative sepsis, blood leakage, and kidney injury were included in those measures.
The Office of Inspector General (OIG) recently released the 2021 version of its annual publication on unimplemented recommendations, which lists overpayments from incorrectly assigned severe malnutrition diagnosis codes as a top concern.
