Primary care clinicians overestimate the probability of disease before and after diagnostic testing, which likely leads to overutilization of treatment that could harm patients, according to a study published in the...Read More »
Hospitals that successfully participate in the Hospital Inpatient Quality Reporting program and are meaningful EHR users could see a 2.8% payment increase, if the...Read More »
Suggested changes for the fiscal year (FY) 2020 Inpatient Prospective Payment System (IPPS) payment rule for acute and long-term care hospitals were released this week, Tuesday, April 27. The IPPS governs how hospitals get paid for services they provide to Medicare patients. Every year, CMS...Read More »
When faced with a body mass index (BMI) denial, I have used the following Coding Clinic references with no luck:
Coding Clinic, Fourth Quarter, 2018, p. 77: "obesity and morbid obesity are always clinically significant and reportable when documented by the provider. In
It’s Health Information Professional (HIP) Week and that makes it the perfect time to celebrate the HIM professionals in our lives! Whether your CDI team includes HIM/coding credentialed individuals or not, CDI professionals by nature of their roles interact...Read More »
Does anyone review inpatient psyche as part of their workflow? We are being asked to explore this and have done a small sample of reviews. We are finding minimal outcomes of any kind, but we do not really understand how these are paid (for Medicare). Does anyone have any experience with this...Read More »
It’s easy to complain about CMS rules, regulations, and coding guidance from the likes of the Cooperating Parties or the American Hospital Association’s (AHA) Coding Clinic. Certainly, over the years we’ve seen guidance we’ve disagreed with, or believed...Read More »