Q: If a patient is admitted for anemia related to a malignancy and is treated only for anemia, the principal diagnosis goes to the malignancy. I understand that the malignancy was the root cause of the condition making it the principal...Read More »
Though many coders and auditors say so, there is no official direction that states diagnoses can only be reported if they’re included in the discharge summary. We teach in our CDI Boot Camps that, although it’s desirable if the...Read More »
CMS released a change request May 30 describing changes which will be implemented in the July 2017 quarterly update to the outpatient prospective payment system (OPPS...Read More »
CMS released the final 2018 ICD-10-CM code set for October 1 implementation this week. The update includes codes relating to cardiac conditions, substances, and myocardial infarctions (MI)—to name a few.Read More »
Researchers studying ED visits at a freestanding academic children’s hospital from June 1, 2013, to May 31, 2015, found that electronic alerts help reduce missed pediatric sepsis diagnoses by 76%,...Read More »
Q: At my institution, we typically do not capture the pleural effusions noted and documented with a congestive heart failure (CHF) exacerbation unless a pleural tap was completed. Coding Clinic states it is acceptable to...Read More »
Editor’s note: This article originally appeared in the Revenue Cycle Advisor. For more information about Hierarchical Condition Categories (HCCs), read ...Read More »
Freedom Health and Optimum Healthcare, two large health insurers based in Florida, are paying $32.5 million to resolve a federal and state investigation into claims they defrauded CMS by submitting risk adjustment scores that improperly inflated their Medicare Advantage reimbursement,...Read More »
