News

Hospitals need to submit Medicare bad debt lists on their cost reports. I was working on a project recently, reviewing bad Medicare debts for a client. I noticed a reduction for a code I do not see a lot on a claim with Medicare primary and Medicaid secondary. It was…
Confusion and apprehension surround new guidelines for deep-tissue pressure injury. The release of the 2020 Official Guidelines for Coding and Reporting (OCG) has resulted in confusion and apprehension surrounding the intent of the new guideline related to the new ICD-10-CM codes for pressure-induced deep-tissue damage, or deep-tissue pressure injury (L89.-6).…
Coronavirus is now a global public health emergency. EDITOR’S NOTE: This is a developing story and ICD10monitor will continue to update you on the latest development on this global health crisis. The World Health Organization (WHO) declared the novel coronavirus a global public health emergency on Jan. 31. As of Feb.…
Case study proves the need for physicians to be members of the CDI team. Having a strong denials management team is critical for facilities. If providers do not leverage proper resources to generate strong appeal letters, the third-party payers will uphold their decisions to remove or change diagnosis or procedure…
The symptoms for CTE include depression, anxiety, explosive anger, suicidal thoughts, and actions. Today, millions of people are looking over their shoulders. They are doing so because they are being stalked. They are being stalked by their own brain. Their brain is thinking about chronic traumatic encephalopathy (CTE). Sadly, as…
The number of conditions a patient has is now going to factor into the risk adjustment score (RAS). EDITOR’S NOTE: Dr. Erica Remer reported this story live during the January 21 edition of Talk Ten Tuesdays. The following is an edited transcript of her reporting. In March, I make my…
Prior authorization is mostly a manual process.  Prior authorizations are not going anywhere anytime soon, but drastic changes on how they are handled may finally be on the horizon. An April 2018 study from the Government Accountability Office found that Medicare prior authorization programs saved the program between $1.1 billion…
In the continuous pursuit of improved efficiencies, can single-source coding be a solution? As organizations continue to evaluate the most efficient and cost-effective ways to streamline operations, there is increasing movement toward single-source physician and facility emergency room coding. This has proven to be a successful endeavor for many organizations,…