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 »
Back in the day (oh, about nine years or so ago), I found myself tucked into my office late into a Thursday evening skimming the tome that was the Office of the Inspector General’s annual Work Plan release. TheWork Plan is—just as its name implies—an outline or agenda of...Read More »
