The ICD-10-CM Official Guidelines for Coding and Reporting provide a roadmap for accurate diagnosis coding. Kimberly Lee, M.Ed., RHIA, CCS-P, unpacks fundamental ICD-10-CM coding concepts.
The 2023 Inpatient Prospective Payment System (IPPS) final rule includes a welcome payment rate increase, coding updates, and adjustments to quality and reporting programs. Review the major provisions of the rule to ensure your organization is in compliance.
The variety of sources for commercial insurance requirements can present challenges to the utilization review (UR) specialist, as UR rules for every patient could differ depending on his or her insurance and that insurer’s policies. Apply these lessons to help UR manage commercial insurance requirements.
In early June, Congress released a bipartisan draft bill called the American Data Privacy and Protection Act. The goal of this bill is to create a regulation that organizations in any industry would need to accord with compliance. On the surface, this sounds great, but in reality, it is unrealistic.
Jessie, a nurse case manager, feels healthcare has changed since the beginning of the pandemic. She believes that the greatest change comes from the recent initiation of new healthcare coverage plans, primarily Medicaid managed care and Medicare Advantage.
This week’s Medicare updates include new items added to the OIG Work Plan, an extension for certain payment rate adjustments for low volume and Medicare dependent hospitals, and more!
