CMS’ 2024 OPPS proposed rule, released in July, details major changes to price transparency requirements and proposes numerous changes to behavioral health reimbursement, coverage of dental services, and more.
The fiscal year 2024 IPPS final rule, released in August, provides updates on inpatient hospital reimbursement, ICD-10-CM/PCS coding and DRG changes, quality and reporting programs, and more.
Surgeons are often the toughest contingent of any medical staff with which a CDI program must make headway. Understanding a little surgeon psychology is the key to making positive inroads. Surgeons see themselves as “doers” or “fixers,” while they consider most other medical specialties as “thinkers” who are not “doers.”
CMS’ 2024 OPPS proposed rule, released July 13, details major changes to price transparency requirements and proposes numerous changes to behavioral health reimbursement, coverage of dental services, and more.
CMS released the fiscal year 2024 ICD-10-CM Official Guidelines for Coding and Reporting on July 5. The release included updated language and examples for reporting COVID-19 preoperative testing, sepsis, the coma scale, and other conditions.
Q: What are some tips for organizations that are just starting out capturing the type of information to report social determinant of health (SDOH) diagnoses in ICD-10-CM?
As the COVID-19 public health emergency has ended, audits are likely to pick up steam. To prepare for this increase in audit activity, it’s essential for providers and coders to examine both current and upcoming trends.
Kate Siemens, RN, CMSRN, CCDS, conducts an interview with Majed Gharfeh, MD, to offer a physician’s perspective on queries and tips on how coders can receive the best results from querying their providers.
As the COVID-19 public health emergency has ended, audits are likely to pick up steam. To prepare for this increase in audit activity, it’s essential for providers and coders to examine both current and upcoming trends.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS, describes how coding reviews provide an opportunity to conduct a thorough compliance review that not only addresses components of the coding process, but also the integrity of the patient’s record. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Learn about the challenges faced and collaborative opportunities encountered by one organization when it began the process of improving its observed-over-expected mortality ratio.
Rose T. Dunn, MBA, RHIA, CPA/CGMA, FACHE, FHFMA, CHPS, describes how coding reviews provide an opportunity to conduct a thorough compliance review that not only addresses components of the coding process, but also the integrity of the patient’s record.
Key performance indicators are used by organizations to monitor the progress of CDI initiatives. Waldo Herrera, MD, MBA, MSc, FACP, SFHM, CHCQM-PHYADV , describes performance metrics that professionals at his facility use to track revenue cycle performance and opportunities for improvement.
The gap between clinical reality and coding terminology can be addressed by empowering coders to use clinical judgment. Merle Zuel, RN, CCDS , discusses when it is appropriate for coders to interpret provider documentation and use their clinical judgment to code it in a certain way.
What may be considered a simple task, such as confirming present on admission status, can be complicated by discrepancies between coding and quality reporting criteria. Kate Siemens, RN, CMSRN, CCDS , outlines the ways in which coding and quality metrics do not align.
Kerri Swart, RN, CCRN, CCDS, writes about how a previously 100%on-site CDI program shifted to remote work and maintained productivity and education standards.
Coding audits are often a source of irritation in small and large practices alike. This article covers common misconceptions about the auditing process and offers tips from experts on how to correct them.
Healthcare providers know that denials are not a matter of if, but when. One way to prevent and manage denials is by looking for opportunities to involve other departments.
What may be considered a simple task, such as confirming present on admission status, can be complicated by discrepancies between coding and quality reporting criteria. Kate Siemens, RN, CMSRN, CCDS , outlines the ways in which coding and quality metrics do not align.
