Outpatient clinical documentation improvement plays a critical role in establishing medical necessity, supporting accurate coding and reimbursement, and reducing claim denials.
As coding teams collaborate across regions and contribute to shared quality and artificial intelligence (AI) evaluation initiatives, a common framework for measuring coding quality becomes essential.
Outpatient follow-up after psychiatric hospitalization among patients with first-admission schizophrenia was associated with a significantly lower risk of readmission, according to a new study.
HIM departments are increasingly being drawn into revenue recovery decisions while also being asked to help ensure coding and documentation workflows remain accurate, traceable, and defensible.
Healthcare organizations have made substantial progress in exchanging health information, but greater connectivity is exposing another set of challenges for HIM departments.
This week’s Medicare updates include waivers and flexibilities available in response to Hurricane Isaias, revised versions of the October 2026 OPPS addenda, and more!
Our experts answer questions about coding a history of Clostridioides difficile infection, repairs of nasal vestibular stenosis and nasal valve collapse, and establishing medical necessity in outpatient settings.
CMS published the October 2026 update to the Outpatient Prospective Payment System (OPPS), which includes changes to codes, status indicators, and payment rates.
CDI can serve as a valuable partner to quality and coding colleagues in understanding the technical details of patient safety indicators, which have a tangible impact on reputation, quality metrics, and financial outcomes.
CMS has named the 2,217 acute care hospitals that are required to participate in its upcoming Comprehensive Care for Joint Replacement Expanded (CJR-X) model.
