Renewed interest in ICD-10 education has been prompted by the announcement last Thursday from the Centers for Medicare & Medicaid Services (CMS) indicating that the Medicare ICD-10 flexibilities agreement will end and will not be extended beyond Oct. 1, 2016.CMS also stated that Medicare would not “phase in” the requirement…
The 2017 Inpatient Prospective Payment System (IPPS) final rule brings with it a number of changes that are likely to have an even bigger impact on documentation, coding, and revenue than ICD-10 itself. An unprecedented number of dramatic changes will go into effect on Oct. 1.I knew that things were…
Renewed interest in ICD-10 education has been prompted by the announcement last Thursday from the Centers for Medicare & Medicaid Services (CMS) indicating that the Medicare ICD-10 flexibilities agreement will end and will not be extended beyond Oct. 1, 2016.CMS also stated that Medicare would not “phase in” the requirement…
One item that has not yet received much attention is a guideline addressing the ability of a facility to report or not to report a diagnosis provided by a physician.What is a facility to do when a physician documents a diagnosis that may be unsupported by the clinical circumstances reflected…
We all know how important clinical documentation is to patient care, and from a compliance standpoint, it is also crucial to auditing – but for those dealing with the financial side of healthcare, the importance may translate into reimbursement losses. Let us look at a clinical scenario.Say an 80-year-old male…
The Centers for Medicare & Medicaid Services (CMS) released the Inpatient Prospective Payment System (IPPS) final rule for the 2017 fiscal year on Aug. 2, one day after its federally mandated deadline. This final rule will be effective for inpatient discharges taking place on and after Oct. 1, 2016.There were…
Last spring I wrote about the new third definition of sepsis with a fair amount of enthusiasm and excitement. From my perspective, this new definition was the answer to the ever-present criticism of sepsis criteria – namely, the notion that people who meet the criteria often are not septic. The…
One of the most vexing issues coding professionals face when coding for infusions and drug administration is the absence of start and stop times.According to the Centers for Medicare & Medicaid Services (CMS) Transmittal 902, hospitals are to report codes that indicate the actual time in which an infusion is…
EDITOR’S NOTE: This is the final installment of a two-part series that examines episodes of care as healthcare payment model. Part I was published on July 19, 2016. The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array…
EDITOR’S NOTE: This is the first in a two-part series that examines episodes of care as healthcare payment model. Part II will be published on July 26, 2016.The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array…