Audits are being conducted by payers on being cost-effective with “wastage” of medication. When it comes to the JW modifier for discarded medication, there are things of which you might not be aware, especially, the administration of expensive pharmaceuticals such as chemotherapy. The verbiage that everyone is familiar with is…
While most legacy clinical documentation improvement (CDI) programs have been doing a good job at preserving revenue under the MS-DRG system, a potential blind spot exists. Value-based and alternative payment models (APMs) rely on the concept of risk adjustment to determine final payment in acute care. The Centers for Medicare &…
While most legacy CDI programs have been doing a good job at preserving revenue under the MS-DRG system, a potential blind spot exists as Value-Based and Alternative Payment Models rely on the concept of Risk Adjustment to determine final payment in acute care. The Centers for Medicare & Medicaid Services risk…
One thing always remains the same in healthcare: change. With the implementation of ICD-10 we found out how disruptive some of these changes can actually be, and it appears that this was only a precursor to even more change in healthcare, with the implementation of new quality payment initiatives.During the…
EDITOR’S NOTE: Hard on the heels of one of the deadliest Middle East bombings in more than a decade in which 175 people were killed in Baghdad on one of the final days of the Islamic holy month of Ramadan, came last week’s wave of domestic violence. So with violent demonstrations here at…
There are 123 pending changes to coding for ophthalmology for this coming October due to additions, deletions, and revisions of the ICD-10 coding set. The coding for conditions related to the eye in ICD-10-CM has become much more in-depth and requires the coder to have a greater understanding of anatomical…
It is time to perform an assessment of your facility or practice in order to evaluate your ICD-10 progress and to uncover potential issues that might affect productivity, risk, or cash flow. Also, by conducting an assessment, you can identify opportunities for improvement, additional training needs, documentation assistance, or operational…
Health plans nationwide are touting widespread success in the implementation of ICD-10, according to comments made by three health plan representatives during the most recent edition of Talk Ten Tuesdays, the weekly Internet broadcast hosted by ICD10monitor.com.
Here are some lessons learned over the last year as we have prepared for an organization-wide approach to implementing ICD-10 across a very large health system in San Diego. There are three specific areas that should be considered when  implementing a new coding process for hospice programs, which went into…
Here are some lessons learned over the last year as we have prepared for an organization-wide approach to implementing ICD-10 across a very large health system in San Diego. There are three specific areas that should be considered when implementing a new coding process for hospice programs, which went into…
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