Coding practices by Medicare Advantage insurers make members seem sicker, which resulted in an extra $33 billion in payments from the federal government in 2021, relative to coding by traditional Medicare providers, according to a study published by the Annals of Internal Medicine .
A review of 800 studies found that electrocardiogram interpretation assisted by artificial intelligence has the potential to improve diagnostic accuracy and enable earlier detection of cardiac conditions, particularly in resource-limited outpatient settings.
It’s been two weeks since the federal government shutdown began, as well as when Medicare telehealth waivers and flexibilities were set to expire. In a special edition of the MLN Connects newsletter released just as the shutdown began on October 1, 2025, CMS provided some guidance to providers. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS recently released an updated MLN fact sheet reminding providers when a transcatheter tricuspid valve replacement for symptomatic tricuspid regurgitation can be covered under the coverage with evidence development policy. Included are the ICD-10-CM/PCS codes that must be reported for inpatient cases.
A study published by the Journal of the American Heart Association found that ischemic heart disease death rates fell 81% from 1970 to 2022 while deaths from heart attacks decreased 89%. However, deaths from other types of heart disease increased by 81% during the same period.
The Agency for Healthcare Research and Quality has released the 2025 Patient Safety Indicators (PSI) updates and revisions. Review the changes in more detail and discover which outdated indicators have been removed and which indicators have been modified.
The implementation of the 21st Century Cures Act has resulted in radiology patients in the outpatient setting being able to view their examination results quicker, according to a study published in JAMA Network Open.
CMS recently released an updated MLN fact sheet reminding providers when implantable pulmonary artery pressure sensors for heart failure can be covered under the coverage with evidence development policy. Included are the ICD-10-CM/PCS codes that must be reported for inpatient cases.
A study published in Respiratory Care found that integrating respiratory therapists (RT) in a chronic obstructive pulmonary disease (COPD) clinic led to significant improvements in symptoms and exacerbation rates among patients, as well as a reduction in hospitalizations.
CMS released the fiscal year 2026 Inpatient Prospective Payment System final rule on July 31, which will provide a 2.6% payment increase for hospitals instead of the original 2.4% considered in the proposed rule. Among other provisions, the rule will continue the mandatory Transforming Episode Accountability Model and modify various quality reporting programs.
A recent Springer Nature study found an increase in Acinetobacter baumannii infections between 2018 and 2021 and carbapenem-resistant A. baumannii (CRAB) infections between 2018 and 2022. The presence of the bacteria was identified in 1% of hospitalized U.S. patients, and over one third of A. baumannii cases were CRAB, designated by the WHO as a critical pathogen in need of new antibiotics.
The calendar year 2026 OPPS and ambulatory surgical center (ASC) proposed rule, released on July 15, details payment updates, services covered, outpatient service volume, and quality reporting, among other proposals.
CMS recently published the fiscal year 2026 ICD-10-PCS code set and official guidelines. Although CMS made no significant changes to the guidelines, the ICD-10-PCS code set includes 156 new codes, 27 deleted codes, and four new tables.
CMS recently released the fiscal year (FY) 2026 ICD-10-CM update, which includes 487 new diagnosis codes effective October 1, 2025. The new codes cover a range of diagnoses, so be sure to review the code update files.
CMS recently announced plans to enhance its auditing efforts for Medicare Advantage plans by increasing the number of audits it conducts and expanding its team of medical coders.
AHIMA is currently accepting submissions for research-driven content to be featured in our Poster Sessions at AHIMA25 Conference, October 12-14 in Minneapolis, MN. If your poster is selected, one...
Clients who participated in court-ordered assisted outpatient treatments (AOT) displayed significant improvements across several outcome measures, according to a study recently published in Psychiatric Research and Clinical Practice.
The National Institutes of Health recently released a study that found an artificial intelligence screening tool was as effective as healthcare providers in identifying hospitalized adults at risk for opioid use disorder and referring them to inpatient addiction specialists. The tool also has the potential to reduce readmissions.
