This week's note from the instructor discusses the steps involved in the prior authorization process for certain hospital outpatient department services.
Review ICD-10-PCS updates that take effect in October, including changes to the Medical and Surgical, Administration, Extracorporeal or Systemic Assistance and Performance, and Imaging sections.
In the 2027 Medicare Advantage (MA) and Part D rate announcement, CMS highlighted risk adjustment accuracy, payment integrity, and accountability for diagnoses that drive reimbursement.
A recent report shows that HIM tasks are becoming increasingly susceptible to automation, but experts caution that AI exposure should not be confused with immediate job displacement.
Improving patient access starts with examining the operational processes behind every request—from intake and staff training to workflow monitoring and executive oversight.
Congenital heart defects are common in pediatric documentation, yet their presence alone does not ensure they are appropriately reported or fully understood within the clinical context of an encounter.
It’s essential to go beyond surface-level knowledge and gain a true understanding of how and why social determinants of health (SDOH) data is important to track, especially for pediatric patients.
