News & Analysis

January 1, 2021
Briefings on APCs

Section 1862 (l) and Section 1869 (f)(2)(B) of the Social Security Act (the Act) sets forth general procedures to develop and evaluate Medicare coverage determinations that are either adopted nationally by CMS or created and applied locally by a Medicare Administrative Contractor (MAC) within the MAC’s own jurisdictional boundaries.

January 1, 2021
Briefings on APCs

Hospital coding for pregnancy-related services requires a detailed understanding of the CPT® global obstetric (OB) package and ICD-10-CM coding guidelines for maternal care management. This article details hospital coding for pregnancy and delivery complications and procedures used to treat them.

December 30, 2020
HIM Briefings

Use this sample billing and charge audit procedure as a template for your organization.

December 25, 2020
Case Management Monthly

Due to the public health emergency brought about by the novel coronavirus (COVID-19) pandemic, organizations got a temporary reprieve from implementing some of the changes brought about by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, which was finalized on September 28, 2019.

December 25, 2020
Case Management Monthly

During the novel coronavirus (COVID-19) pandemic, it has become abundantly clear that the burden from this disease has not been shared equally. Minorities have been disproportionately affected by everything from economic fallout to disease severity and prevalence.

December 25, 2020
Case Management Monthly

Lidia's husband, Henry, hears his wife scream in the middle of the night. He quickly responds and finds her on their bathroom floor in a pool of blood. He has never seen so much blood and feels frightened for his wife.

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