Q:We’ve encountered audit takebacks and denials from a certain payer who removed codes and procedures that result in lower DRGs. Do you have any advice for fighting or preventing these types of denials?Read More »
Starting this year, CMS plans to conduct an annual call for measures related to the Medicare EHR Incentive Program, the agency announced last week.Read More »
The conversation bounced around the importance of building a community of caring. The speakers talked about the development of family and the communities that extended families create. They also spoke of changing societal norms which make geographic, topic-...Read More »
FEATURES 7 Concurrent coding 12 CMS-HCC version 23 released 17 Mortality reviews and publicly reported quality scores 25 Submit questions to Coding...Read More »
by Melissa Varnavas
It’s that time of the year again: time to pull down the tome that is the inpatient prospective payment system (IPPS) final rule and mine its pages for changes relevant to daily CDI reviews. While intimidating at more than 600 pages, the IPPS rule can be broken...Read More »
Medicare incorrectly paid approximately $1.7 million to Carolinas Medical Center in Charlotte, North Carolina, as a result of incorrect billing on the part of the medical center.Read More »
By Sam Antonios, MD, MMM, FACP, SFHM, CPE, CCDS
Consider the story of a patient—say, a pneumonia patient—whose treatment cost a lot of money. The hospital’s reimbursement for that care, however, was less than the cost of providing it. Now say someone looked at that case and how...Read More »