The American Hospital Association (AHA) expressed concerns about the 2017 inpatient prospective payment system (IPPS) proposed rule, including the documentation and coding adjustment (DCA), changes to disproportionate share hospital (DSH) payments, and the implementation of various quality...Read More »
CMS underpaid Medicare Advantage plans for the cost of treating patients with multiple chronic conditions, which the organization admitted to in November. However, a new report from healthcare consulting company, Avalere Health, shines a light on some of the specifics. Read More »
I have previously addressed the issue of auditor denials. However, given the industry changes I have witnessed in the last 12–18 months, it is time to revisit this problem. And, per communications with colleagues in the CDI world, I suspect the same...Read More »
For calendar years (CYs) 2012 and 2013, Medicare overpaid Nebraska Methodist Hospital in Omaha more than $111,000 for 19 inpatient and outpatient claims, including insufficiently documented sepsis and septic syndrome.Read More »
The MS-DRG shift driven by the switch to ICD-10 will impact diagnoses throughout ICD-10-CM, says Gloryanne Bryant, RHIA, RHIT, CCS, CDIP, CCDS, an AHIMA-approved ICD-10-CM/PCS trainer with more than 30 years of experience in HIM.
Not otherwise specified (NOS) codes offer...Read More »
With the release of the 2017 Inpatient Prospective Payment System final rule on August 2, 2016, CMS announced a delay in implementation of the NOTICE act. CMS is submitting a revised version of the Medicare Outpatient Observation Notice (MOON...Read More »
Hospitals are reporting a decrease in improper payments, according to the U.S. Department of Health and Human Services (HHS) annual Agency Financial Report.Read More »