As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption.
Developing an outpatient CDI program isn't just about metrics--departments needs to consider how to engage providers and interact with other teams to be truly effective.
It's been more than three years since CMS introduced a subset of modifiers it wants providers to report instead of modifier -59 (distinct procedural service), but they're still optional as barely any new guidance has been released.
CMS recently released updated guidance on billing intensity-modulated radiation therapy (IMRT) after an OIG audit found a 100% error rate in billing certain IMRT planning services.
This month we are pleased to introduce Roger Hettinger , RHIA, CCS, CCS-P, COC, CPC, CPCO, CPB, CPMA, CRC, CEDC, CGSC, CHONC, CIMC, CUC, CGIC, CHC, CRCR, Senior Revenue Cycle Advisor for Axea Solutions, Inc. in Cumming, Georgia.
The official version of the fiscal year (FY) 2019 IPPS final rule was recently published in the Federal Register . This rule, which became effective on the first of October, contains key financial information, including certain payment factors, based upon the government’s best estimate at the time of publication.
The verdict is in. CMS’ fiscal year (FY) 2019 IPPS final rule took effect on October 1 and impacts 3,300 hospitals. CMS made changes to several of its inpatient quality programs: Hospital Value-Based Purchasing Program, Hospital-Acquired Condition Reduction Program, and Hospital Readmission Reduction Program, in addition to the changes made to ICD-10 CM/PCS codes.
CMS recently released the fiscal year (FY) 2019 IPPS final rule with significant reductions to reporting requirements for quality initiatives, changes to CC/MCC designations, and revisions to various MS-DRGs.
The most recent quarterly update to the influenza virus vaccine code set includes a new HCPCS influenza virus vaccine code approved for use in 2019, according to CMS Transmittal 4127.
Medicare guidelines for reporting arthroscopic shoulder surgeries have changed significantly over the past decade. Review updated guidance and CPT coding for SLAP repairs as well as biceps tenotomy and tenodesis procedures to reduce audit risk. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: I received confusing guidance regarding CPT coding for a segmental spinal fusion with pedicle screws placed at L3 and L4 vertebrae. Would it be appropriate to report CPT code 22612 with add-on code 22614 for this procedure?
Coding leadership can assist the chargemaster team by providing input, preparing appeals, and tracking coding-related denials. Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS , describes how to effectively work with a team of coders to combat continued denials.
Peggy S. Blue, MPH, CPC, CCS-P, CEMC , reviews the key characteristics of physician visits administered to patients in skilled nursing facilities and E/M coding for these services.
Q: Our team is having a hard time determining a principal diagnosis for a patient with a history of stage 5 chronic kidney disease (CKD) who is receiving chronic hemodialysis and is in acute renal failure (ARF) with volume overload. Which ICD-10-CM code should be the principal diagnosis?
Allen Frady, RN-BSN, CCDS, CCS, CRC, says that defending code assignment against denials requires more than reviewing the denial to determine if the condition was coded and reported according to the coding guidelines; it requires an understanding of payer requirements as well.
Inpatient coding audits need to be tailored to the type of record being reviewed, the time it may take to complete the audit, and any compliance-related issues that may crop up. This article focuses on how coding managers can streamline these aspects to ensure a successful audit. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Early readmissions were more likely to be preventable and amenable to hospital-based interventions, according to a recent study published in the Annals of Internal Medicine.
William E. Haik, MD, FCCP, CDIP, writes that complex pneumonias can segregate to a higher-weighted MS-DRG than other pneumonia types, so reviewing clinical elements with your physician staff may help improve documentation and avoid adverse determinations by external reviewers for these conditions.
