Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O, reviews the latest guidance and ICD-10-CM reporting for common novel coronavirus (COVID-19) scenarios such as reporting for patients who present for testing with symptoms of COVID-19.
Like other services covered by Medicare, observation must be reasonable and necessary or, in other words, medically necessary. The physician must document that they assessed patient risk to determine that the patient would benefit from observation services.
In today’s continually changing healthcare environment, increasing demands to share patient information create complex challenges. Learn how to optimize staffing and technology to ensure efficient and compliant release of information (ROI).
The Office of Inspector General (OIG) will be taking a closer look at how health risk assessments influence Medicare Advantage risk scores and risk-adjusted payments, according to its recently updated Work Plan.
A recent audit conducted by the Office of Inspector General (OIG) found that the majority of healthcare providers reviewed used Medicare Part D eligibility information for potentially inappropriate purposes.
One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.
Carolinas Hospital in Florence, South Carolina, received $431,757 in Medicare overpayments for incorrectly billed inpatient and outpatient services, according to an Office of Inspector General (OIG) audit report released November 26. Based on the sample, the OIG estimates the hospital may have received at least $3.4 million in overpayments.
The U.S. healthcare system wastes some $760 billion to $935 billion dollars each year, says a recent study published in the Journal of the American Medical Association, and between $27.2 billion and $78.2 billion of that total is the result of failures in care coordination.
In today’s virtual environment, with its focus on flexible schedules, organizing the coding function requires consideration of time zones, team member skills, volume of work, and claim-processing schedules.
Along with its annual updates to the inpatient-only list, the 2020 Outpatient Prospective Payment System (OPPS) final rule finalized a proposal that will give hospitals a grace period to adjust internal policies for procedures recently removed from the inpatient-only list.
