Among the proposed changes, many of which affect quality and data reporting programs, are proposed changes to claims data used for rate setting, a delay of the three way split criteria for Medicare Severity Diagnosis-Related Groups (MS-DRG), and more. Understand major proposals and their potential impact and how to provide feedback to CMS.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, unpacks local and national medical necessity standards and best practices for avoiding denials due to inadequate documentation.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, describes the difference between an implant and a foreign body removal and outlines CPT coding for these procedures.
As hospitals face mounting challenges, preventing and managing denials is more important than ever. Learn how to use data from electronic remittances to conduct root cause analysis and stay ahead of potential future denials.
