Anemia describes a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient. Review the types of anemia, diagnostic criteria, treatment, and ICD-10-CM coding. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The healthcare setting can feel like a courtroom in the denials and appeals arena. By assessing the effort that goes into an appeal and the difference that comes out of them, coders and CDI specialists may find that the chasm between clarifying a patient record and defending it isn’t as wide as they think.
U.S. government civil healthcare fraud settlements exceeded $1.6 billion in 2022, according to the recently released 2022 Health Care Fraud and Abuse Control Program Annual Report.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a broad federal law that establishes the basic privacy and security protections that coders are required to follow.
Part B physicians will have to prepare for a net 3.4% payment decrease across services in 2024, according to the 2024 Medicare Physician Fee Schedule final rule, which covers numerous operational areas for medical groups, including new coverage opportunities and billing revisions to coding and compliance updates.
The National Correct Coding Initiative released the 2024 NCCI Policy Manual in early December, which will be effective January 1. This article covers the changes—both big and small.
Our experts answer questions about finding the right assessment tool for reporting social determinants of health, choosing CPT modifiers for same-day services, and more.
The 2024 OPPS final rule details changes to price transparency compliance, reimbursement changes and, updates to numerous other hospital programs. Additionally, CMS is moving forward with its proposals to address unlawful payment reductions to 340B drug reimbursement.
After years of working to engage providers and get them on board with CDI efforts, every seasoned CDI professional knows there’s no one-size-fits-all solution.
Anemia describes a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient. Review the types of anemia, diagnostic criteria, treatment, and ICD-10-CM coding.
As more health systems have been forced to reckon with the undeniable impacts of socioeconomic status on health outcomes, CDI and coding practices have followed in kind. Analyze recent developments with reimbursement and ICD-10-CM coding for social determinants of health (SDOH).
The Journal of the American Medical Association recently released a study that analyzed social determinants of health and other conditions associated with lower-limb amputation in the U.S.’ most populated areas. The study found that several factors corresponded with an increased risk of amputation.
Debbie Jones, CPC, CCA , examines the cause, prognosis, and treatment options for desmoid tumors, in addition to reviewing the ICD-10-CM codes designed to identify them with specificity. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Medical coding practices can vary widely between countries, with different code sets, regulations, and policies governing the process. However, there are some commonalities when comparing medical coding in the U.S. to other countries, which this article explores.
Q: I’ve heard some facilities are beginning to incorporate ICD-11, even though it is not yet implemented in the U.S. How can coders help their providers transition to ICD-11?
Part B providers will have to prepare for a net 3.4% payment decrease across services in 2024, according to the 2024 Medicare Physician Fee Schedule final rule. The rule covers numerous operational areas for medical groups, including new coverage opportunities and billing revisions to coding and compliance updates.
The 2024 OPPS final rule details changes to price transparency compliance, reimbursement changes and, updates to numerous other hospital programs. Additionally, CMS is moving forward with its proposals to address unlawful payment reductions to 340B drug reimbursement.
A recent Office of Inspector General audit of inpatient and outpatient Medicare claims estimated that nearly 20% of cases including codes for abuse or neglect were not reported to law enforcement.
