News

You may be noticing an uptick in cerebral edema clinical validation denials. Here’s my take. There are two distinct cerebral edema codes. They both serve as major comorbid conditions or complications (MCC). Non-traumatic conditions which are accompanied by cerebral edema get the code, G93.6 from the Diseases of the nervous…
With the reimbursement so complex and antiquated, should Congress investigate? Medicare reimbursement payments to hospitals for graduate medical education are based on calculations so complicated, it boggles the mind.  The computation for direct graduate medical education (GME) payments starts with an allowable cost per resident (ARPA) determined in the early…
Guidance and advice effective with discharges occurring on and after June 21, 2019. The American Hospital Association (AHA) Coding Clinic for ICD-10-CM/PCS for the second quarter of 2019 was released last month, and there are some interesting topics and guidance within this volume (Volume 6, Number 2). Due to copyright restrictions,…
“Let me count the ways.” EDITOR’S NOTE: Dr. Remer reported on this topic during the most recent edition of Talk Ten Tuesdays. I have been doing a project evaluating emergency department documentation, and many of the emergency providers utilize voice recognition. As such, illegibility has been replaced by unintelligibility. I…
All bad documentation is based on lies – the lies doctors (and all human beings) tell themselves. We always believe our lies, because they are how we construct a false reality that makes our bad behavior seem acceptable to ourselves. Theologians might call it original sin, humanists might call it…
The Gravity Project will be the editorial focus on tomorrow’s Talk Ten Tuesdays. The latest big development associated with the oft-discussed social determinants of health (SdoH) – a national collaborative funded by the Robert Wood Johnson Foundation – will be reported on during the next upcoming edition of the Talk…
The author shares highlights from the annual conference. I am going to continue my series on what you should know from the sessions I attended at ACDIS. There was just so much excellent material. Sam Antonios did a fantastic presentation on how CDI impacts quality. He explained that some programs…
New patient management service codes. The Medicare Physician Fee Schedule (MPFS) recently added several patient management service codes that have face to face and non-face-to-face components to them for physician reimbursement. One of those services is transition care management (TCM). These CPT® codes allow for reimbursement of the care provided…