Kathleen M. Romero, MSN, RN, EBP-C, Cynthia Beal, MBA-HCM, BSN, RN, and Renee Pate, MSOL, MSN Ed., RN, CCDS, explain how they implemented a CDI program in their facility’s emergency department and the how establishing this program improved coding accuracy and increased reimbursement.
With reimbursement gains whittled down by CMS' attempt to remedy unlawful cuts to 340B drug payments, complying with updated Outpatient Prospective Payment System (OPPS) policies is key to protecting reimbursement. Take a closer look at CMS' latest policies and ensure your organization is in compliance.
The 2023 Medicare Physician Fee Schedule ushered in a slew of changes to payment rates, coding guidelines, and telehealth coverage. Review key changes to ensure your organization is in compliance.
Coding and billing professionals must ensure that medical record information is accurate, up to date, and compliant. In this article, Holly Cassano, CPC, CRC, defines late entries, corrections, and addendums, and explains the proper methods used to alter health records while maintaining Medicare compliance.
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.
A properly calibrated audit tool is key to uncovering educational opportunities for CDI specialists. Use this expert advice to help your organization get the most out of CDI audits.
Various analyses must be conducted to maintain compliance, assist with charge capture, solve account edits, and review any possible coding trends or issues that may cause claim delays, denials, or unnecessary rework. Learn how to effectively leverage this data to improve processes and protect revenue.
Many healthcare systems are looking at how to expand their CDI program to include outpatient and ambulatory settings. Jennifer Boles, BS, COC, CRC, CCDS-O, explores her ambulatory CDI program’s success and offers advice for those looking to expand.
The Office of Inspector General (OIG) recently released a data brief on billing risks associated with Medicare telehealth services during first year of the COVID-19 pandemic.
Starting on October 6, the definition of electronic health information (EHI) will include “the entire scope of the EHI definition [i.e., ePHI that is or would be in a Designated Record Set (DRS)].”
