One size does NOT fit all when it comes to health insurance. Beneficiaries range from the extremely healthy 65-year-old—the poster child for “65 is the new 45”—to a 65-year old suffering from COPD from a lifetime of smoking, cancer, and a hereditary condition such as Type 1 diabetes. The result...Read More »
The American Hospital Association (AHA) is concerned about the documentation and coding reduction, changes to disproportionate share hospital (DSH) payments, and the implementation of many of CMS’s quality programs detailed in the CMS IPPS Proposed Rule for Fiscal Year (FY) 2017, according to a ...Read More »
Recovery Auditor medical record requests and automated and complex denials all fell slightly in the first quarter of 2016, as did the average number of medical record requests per hospital, which decreased slightly since the fourth quarter of 2015, according to the latest RACTrac report...Read More »
CMS issued a final rule last week to revamp the way it pays for tests under the Clinical Laboratory Fee Schedule (CLFS). Now starting January 1, 2018, CMS will base CLFS payments on the weighted median amount paid by private payers for the same services. Providers are hopeful that these new...Read More »
Physician advisors serve a variety of purposes beyond documentation improvement, including assisting case management, utilization review, quality, and coding departments, among other assignments, according to a recent benchmarking report and survey from ACDIS.Read More »
Q: The coders at my facility have stated auto linking congestive heart failure (CHF), hypertension (HTN), and chronic kidney disease (CKD) to the combination code without any documentation of CHF “due to” HTN. There is no documentation of hypertensive heart disease anywhere in...Read More »
On Thursday, July 28, in Holyoke, Massachusetts, CDI and coding professionals from across the New England region will join together for a full-day educational event. On the agenda are sessions about engaging physicians in CDI, a panel discussion featuring documentation improvement from both the...Read More »
ACDIS is seeking feedback on your physician advisor training needs. Please take a moment to answer a short 5-question survey to help us learn what would best serve your needs. Click here to take the survey.Read More »
