News & Analysis

October 12, 2022
Case Management Monthly

In recent years, the Office of Inspector General (OIG) has taken aim at case managers and discharge planners who violated federal anti-kickback statutes—specifically those who took items or payments in exchange for post-acute referrals.

October 5, 2022
Case Management Monthly

Medicare beneficiaries who took part in telemedicine visits during the pandemic were more likely to stick with medication therapies to treat their opioid use disorder (OUD) and less likely to experience a drug overdose, according to a JAMA Psychiatry study. 

September 21, 2022
Case Management Monthly

A report released last month by the American Hospital Association (AHA), called Commercial Health Plans’ Policies Compromise Patient Safety and Raise Costs, found that not only is the cost of private health insurance raising affordability issues for American consumers, but policies, such as prior authorization requirements, may increasingly be putting patients at risk and driving up hospital administrative costs.

September 21, 2022
Briefings on APCs

Effective October 1, the ICD-10-CM code set will be updated to include over 1,100 new codes before counting code revisions and deletions. This article covers new codes for musculoskeletal and genitourinary conditions including muscle wasting, rib and sternal fractures, drug-induced neuropathy, and endometriosis.

August 1, 2022
Briefings on APCs

The 3-day payment rule is known to coders by various names such as the 72-hour rule, the 3-day payment window, or MS-DRG window policy. Kimberly Lee M.Ed., RHIA, CCS-P, describes how to navigate the rule’s nuances for billing purposes.

July 13, 2022
Briefings on APCs

Every organization’s priorities will differ, but any outpatient CDI program must determine how to measure the improvement associated with its efforts. Outpatient CDI will directly contribute to the facility’s overall quality performance and risk adjustment models.

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