News & Analysis

June 8, 2022
Case Management Monthly

For years, case management experts have been urging hospitals to capture the ICD-10-CM Z codes for social determinants of health SDoH. But the message doesn’t appear to be resonating.

June 1, 2022
Briefings on APCs

Hospital coding for wound procedures is notoriously difficult, as the process can seem as messy as the injuries themselves. Clarify wound documentation and guidance for reporting wound diagnoses and procedures using ICD-10-CM, CPT, and HCPCS Level II codes.

May 25, 2022
HIM Briefings

Clinical validation denials can be complex and difficult to appeal. Improve your process by using these tips to craft a clinical validation appeal.

May 11, 2022
Case Management Monthly

Tiffany Ferguson, LMSW, ACM, and Marie Stinebuck, MBA, MSN, ACM, CEO and COO at Phoenix Medical Management Inc., discuss why the best strategy to prevent denials related to medical necessity is a proactive approach that focuses on front-end processes.

May 4, 2022
HIM Briefings

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.

May 1, 2022
Briefings on APCs

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.