News

The Hospital OQR program is a pay-for-reporting quality data program for hospital outpatient services. As a coding professional with 20-plus years of coding and documentation integrity experience under my belt, I humbly recognize that I don’t know everything, and must stay curious and open to learning the ever-changing world of…
Six proposals were not heard during the Coordination and Maintenance committee meeting. The Coordination and Maintenance Committee Meeting was held March 9 – 10, 2021. The meeting began with discussion of the ICD-10-PCS topics. There were six proposals that were not discussed during the meeting which were therapeutic administration of…
Grieving adequately is painful, but the paradoxical outcome can be more resilience and emotional strength. I was so pleased to see that the ICD-10 Coordination and Maintenance Committee of the Centers for Disease Control and Prevention (CDC) was meeting next week, and that prolonged grief disorder was one of the…
This new law is set to take effect on Jan. 1, 2022.  In the closing days of 2020, Congress enacted and the President signed into law the "No Surprises Act."  But what does that mean for providers and patients exactly? The Act contains key protections to hold consumers harmless from…
Whether you work for a full-scale enterprise or a smaller healthcare facility, revenue integrity programs' increasing importance is consistent; beyond ensuring accurate billing and collection, these programs should strengthen reimbursement performance and provide sound financial practices. Revenue cycle management (RCM) is a well-established concept in the business of healthcare, traditionally…
There are certain key elements of consideration during CDI review of COVID-19 patients.  Understanding how to clinically validate sepsis and differentiate between sepsis and septicemia is not easy, and requires a lot of time and effort. Sepsis is an overwhelming non-homeostatic response of the immune system to infection causing organ…
AMA says these are proposed, not finalized. The American Medical Association (AMA) Editorial Panel met in February to discuss proposed changes to the CPT® Code Book. The formal proposal published on March 5 was a reflection of the discussion, and it raised certain issues that stakeholders will now have an…
The report underscores federal authorities’ recent assertions that coding errors are generating ample unwarranted reimbursement. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) just released a data brief titled “Trend Toward More Expensive Inpatient Hospital Stays in Medicare Emerged Before COVID-19 and Warrants Further…