Questions abound when reporting critical care services.Reporting Adult Critical care can be complicated. It is not only the coding but the rules and that go along with critical care.  Many questions come up when reporting critical care services. You would think it would be fairly straightforward since there are only…
Chronic conditions are the driving force in determining healthcare outcomes and costs in today’s value-based world, hence the interest in the Hierarchical Condition Category (HCC) coding payment model. Coding chronic conditions and co-morbidities is becoming increasingly critical as the healthcare landscape shifts toward value-based care. Value-based care attempts to advance…
From evolving your CDI department to a population-centric approach to understanding the impact of electronic medical record technology on CDI program outcomes are among six resolutions offered by the author.Happy New Year! It’s now officially 2018, and even though we are already a full quarter into the federal fiscal year,…
New quality measures have been added to the IRF Compare website in order to assist consumers, although some measures are not included.The Inpatient Rehabilitation Facility (IRFs) Prospective Payment System for federal fiscal year 2018 final rule published Aug. 3, 2017 included the addition of additional quality measures to the IRF…
Eight key guidelines for ensuring proper coding. EDITOR’S NOTE: The following is a summary of a presentation by Margaret Skurka during the 2017 American Health Information Management Association (AHIMA) national convention in Los Angeles. Evaluation and management (E&M) documentation principles have been around a long time – since 1995, in…
November is National Diabetes Awareness Month, prompting coders to review the coding guidelines for this disease suffered by more than 10.9 million U.S. residents.During November, the Centers for Medicare & Medicaid Services (CMS) is raising awareness about diabetes, diabetic eye disease, the importance of early disease detection, and related preventive…
Congress can’t seem to resist tinkering with healthcare through legislation.As we celebrate Halloween, we are seeing healthcare policy “zombies” here in Washington, D.C. – for as many times as congressional leadership has vowed to move on to other legislative topics, healthcare reform seems to always come back to life.The big…
The American Hospital Association steps in; the American Medical Association steps up.On Sept. 27, 2017, the Centers for Medicare & Medicaid Services (CMS) announced that it would not update its overall hospital quality star ratings in October 2017, as planned. This was primarily based on the public's feedback, but the…
Major financial penalties loom for providers not following reporting requirements.We are more than halfway through the first year of the Medicare Access and CHIP Reauthorization Act (MACRA), and a majority of clinicians still do not understand the program.In fact, the Centers for Medicare & Medicaid Services (CMS) reported that an…
MACRA continues to be a subject that perplexes providers even as the program evolves.It has been recently confirmed that the Comprehensive Care for Joint Replacement (CJR) bundled payment has been cut from 67 to 34 percent in the program, and the carding rehabilitation incentive with bundled payments has been cancelled.…