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.
Now that the fourth quarter has arrived, things are winding down for 2022. This is a good time to reflect on the past year of HIPAA compliance and prepare for 2023. Here is a roundup of HIPAA topics and some actionable tips for compliance.
While in the early stages of developing a nationwide directory of providers and services, CMS has already shown a commitment to information transparency. The agency published ownership data for all Medicare-certified nursing homes in September, making it easier to hold owners of multiple facilities—including private equity firms—accountable.
This week’s Medicare updates include the implementation of enrollment and eligibility changes for Medicare as required by the Consolidated Appropriations Act of 2021, revised guidance on staff vaccination requirements, a change to the October 2022 update of the Ambulatory Surgical Center Payment System, and more!
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.
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.
