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.
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.
