News

Do your physicians and ancillary staff know the ICD-10-CM coding rules? Based on many years of personal experience, most physicians and ancillary staff who do not code really don’t know or understand the coding rules.  This is not particularly surprising, because even the best coders are sometimes confused by the…
Three revenue cycle tips are provided to reduce denied claims. Claim denials represent millions of dollars in lost and delayed net reimbursement annually. According to the American Medical Association (AMA), cost estimates of inefficient healthcare claims processing, payment, and reconciliation top out at $210 billion per year. Denials are so…
The SDoH are an essential element to providing patient care while addressing social needs. What determines health? While medical care is one determinant of one’s health, it plays a minor role in comparison to the economic and social conditions of an individual, otherwise known as social determinants of health (SDoH):…
Oct. 1, 2019, marks the beginning of a new era of billing for skilled nursing facilities (SNFs). EDITOR’S NOTE: This article was published on Aug. 1, 2019, in the RACmonitor news and is reproduced today given the approaching deadline for coding compliance. Say goodbye to RUG-IV, and hello to the…
Late physician signatures pose serious issues. In the last few months, I have had questions about late signatures on documentation come in from several clients. I've been hearing about providers signing their notes a very long time after the encounter – sometimes weeks later, sometimes months,  and sometimes even turning…
The author ruminates on the Fall C&M meeting. EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Sept. 17 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. I listened to the ICD-10 Coordination and Maintenance Committee Meeting last week. Here are my thoughts.…
Public comments due by Nov. 8 to CMS and CDC. EDITOR’S NOTE: Senior healthcare consultant Laurie Johnson reported this story live during the Sept. 17 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. The Coordination and Maintenance Committee met on Sept. 10-11, 2019 at the…
If there is no organ dysfunction, it is not sepsis. EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Sept. 10 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. Apparently, I am not done pondering and pontificating about sepsis, which is apropos, considering…