Billing and reimbursement

Assess how to improve documentation and reimbursement for chronic conditions.

Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, explains how to report neonatal respiratory failure, including meconium aspiration, failure to thrive, and associated symptoms in ICD-10-CM.

Peggy Rossi, BSN, MPA, CCM, details current healthcare challenges and advises case managers on how to overcome them.

Ensure your organization is keeping pace with current and upcoming requirements for price transparency compliance.

Tonya Chandler, RHIT, writes about mental health status in youth, clarifies possible contributing factors, and explains how to report mental and behavioral conditions in ICD-10-CM with several case scenarios.

CMS recently released the 2025 Inpatient Prospective Payment System (IPPS) proposed rule, and a notable omission represents good news for case managers.

Orthopedists perform injections and aspirations to address a range of ailments, but reporting injections can be difficult. This article reviews proper CPT coding for sacroiliac joint injections and joint arthrocentesis.

Trey La Charité, MD, FACP, SFHM, CCS, CCDS, analyzes the challenges that both inpatient and outpatient CDI specialists encounter and offers advice to lessen provider opposition to participating in outpatient CDI. 

Shelley C. Safian, PhD, RHIA, CCS-P, and Mary A. Johnson, MBA-HM-HI, CPC, review the purpose of modifiers and analyze their integral part in reporting encounters, receiving reimbursement, and promoting continuity of care.

Shelley Safian, PhD, RHIA, CCS-P, COC, CPC-I, defines the differences between reporting uncertain diagnoses in outpatient and inpatient settings.