On December 7, CMS published a final rule in the Federal Register that will give qualified organizations such as employers and consumer groups access to data to help them identify high quality healthcare providers or create online tools to help consumers make educated healthcare choices...Read More »
While CDI and coding staff members are well versed in assigning a principal diagnosis, they are often less adept at incorporating the concept of medical necessity into their practices, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS. Coders tend to simply code what'...Read More »
The auditing arm of the Department of Health and Human Services (HHS) plans to crack down on hospital performance in the areas of reporting of adverse events and quality measure data, present on admission coding, inpatient outlier payments, and same-day readmissions.
On October 20, CMS released its long-awaited final rule governing accountable care organizations (ACO), with major concessions to the original plan that had soured many healthcare leaders and physicians against participating....Read More »
Coders and CDI specialists need to understand the implications coding and sequencing may have on readmissions data and cohort selection, says James S. Kennedy, MD, CCS, managing director at FTI Consulting in Atlanta and a member of the ACDIS advisory board.