In its January release, The Medicare Payment Advisory Commission (MedPAC) recommended Congress adjust Medicare’s hospital inpatient payments over three years to recover overpayments that have resulted from recent documentation...Read More »
Come October 2013, healthcare facilities will switch from reporting ICD-9-CM codes to the internally accepted ICD-10-CM code set.
CMS developed General Equivalence Mappings (GEMs) in order to help translate ICD-9 codes to ICD-10. Providers can use the GEMs “as a sort of...Read More »
Connolly Healthcare, CMS’ recovery audit contractor (RAC) for Region C, announced its first targets for complex review with a list of 24-DRGs in December 2009. A few weeks later it added 15 more DRGs to its list.
Connolly’s list was the first published, so it provided a good preview
Most organizations evaluate performance by looking at calendar year data, so set aside some time in January to run some reports and analyze your program. If you’re not the data manager for your program, make an appointment to sit down with your data person/report developer/manager to review...Read More »
Let me begin by saying that I want to thank you all for your participation in ACDIS over the course of 2009. ACDIS is in many ways still a small home-grown association, but we’re building a name in the industry. You, our valued members, have helped...Read More »
Some hospitals will start to receive Program for Evaluating Payment Patterns Electronic Reports (PEPPER) this month, according to TMF Health Quality Institute.
TMF contracts with CMS to produce the reports. State Medicare Quality Improvement Organizations previously produced and
Effective January 1, CMS stopped paying for the CPT codes physicians use to bill consultations. This dramatic change provides a window of opportunity for CDI specialists, who are well-positioned to not only break the bad news to physicians, but also provide them with education on how to...Read More »
Septicemia has been problematic for some time. Coders often misunderstand the ICD-9-CM Official Guidelines for Coding and Reporting as it pertains to the sequencing of the assigned codes, says Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CCDS, director of HIM
