News

Fall ICD-10-CM/PCS Coordination and Maintenance Committee Meeting kicks off today. Today and tomorrow mark the dates for the next ICD-10 Coordination and Maintenance Committee meeting. Health information management (HIM) and coding and clinical documentation integrity/improvement (CDI) professionals often wonder about what the Coordination and Maintenance Committee is and does, so…
EDITOR’S NOTE: This article has been updated to include commercial contract coverage information and CPT® direction to challenge payer contract provisions when necessary. Is your medical practice providing smoking cessation counseling and treatment? Did you know you can bill and get reimbursed for your services? There are rules, linked diagnosis…
Moving from the inpatient to the outpatient setting is gaining momentum. Outpatient clinical documentation improvement (CDI) programs are becoming more prevalent in the healthcare sector, as the value and benefit to the revenue cycle have become readily apparent. Consulting companies are developing service lines and software to grow their position…
Data for clinical and business intelligence can uncover significant opportunities within clinical documentation improvement. In my previous article, I discussed the process of how transformational change occurs, through transparency resulting from strategic connectivity across the healthcare system. To expand on this theory, let's examine the current state of clinical documentation…
Where CDI went awry: missing an opportunity for safety. In last week’s ICD10monitor news edition, I authored an article titled “How a Texas Health System Beat a $61.8 Million Billing Fraud Case.” The dismissal of the case was based upon a citation of previous language the Centers for Medicare &…
In search of good collaboration among stakeholders. For many years I’ve been surprised at the various levels of disagreement between staff involving both outpatient and inpatient coding in the physician and hospital settings. Having worked in a production environment, with the need to maintain a good quality score of at…
A look at the proposed Medicare Physician Fee Schedule. As you may be aware, the proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially published on Aug. 14, 2019.  There are many components to the rule, including a proposed change in the PFS conversion factor to $36.09, the…
The author reports on the recent court decision to dismiss a False Claims Act lawsuit against Dallas-based Baylor, Scott & White Health. EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Aug. 27 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. My…