Recent approval of a RAC issue for inpatient hospital claims review has initiated uncertainty and places an onus on providers to lean on CMS guidance and policy manuals. The issue, “inpatient admissions without a physician’s inpatient admit order,” can be referenced in the Medicare Claims...Read More »
As facilities vie for government incentives to implement electronic health record systems they may find CDI programs provide a hidden benefit.
The biggest challenge related to meeting governmental standards for “meaningful use” of EHR “is that they require physician documentation and...Read More »
Confusing coding guidelines and insufficient documentation have made neoplasms a target area as HealthDataInsights—the RAC for Region D—recently said it will take a closer look at MS-DRGs 837–948.
“…[T]here are opportunities for error within this subset of MS-DRGs,” says Paul Evans,...Read More »
The Centers for Medicare & Medicaid Services (CMS) recently approved the first “medical necessity review” audits for the recovery audit contractor (RAC) program,...Read More »
Three types of mistakes—insufficient documentation, miscoded claims, and medically unnecessary services and supplies—accounted for nearly 98% of errors common across six different provider types, according to the July 14 report ...Read More »
In response to a 30-question survey, 482 CDI professionals provided data about the number of staff they employ, the number of queries they generate, and the number of chart reviews their staff perform. They offered information on the focus of their CDI programs and to whom their CDI specialists...Read More »
There may be hope for hospitals carefully watching the proposed IPPS rule, praying for some amelioration of the suggested 2.9% documentation and coding adjustment (DCA) it included. On July 12, 242 members of Congress...Read More »
