Outpatient clinical documentation improvement plays a critical role in establishing medical necessity, supporting accurate coding and reimbursement, and reducing claim denials.
HIM departments are increasingly being drawn into revenue recovery decisions while also being asked to help ensure coding and documentation workflows remain accurate, traceable, and defensible.
CMS published the October 2026 update to the Outpatient Prospective Payment System (OPPS), which includes changes to codes, status indicators, and payment rates.
This week’s Medicare updates include waivers and flexibilities available in response to Hurricane Isaias, revised versions of the October 2026 OPPS addenda, and more!
CMS has named the 2,217 acute care hospitals that are required to participate in its upcoming Comprehensive Care for Joint Replacement Expanded (CJR-X) model.
