Among the proposed changes, many of which affect quality and data reporting programs, are proposed changes to claims data used for rate setting, a delay of the three way split criteria for Medicare Severity Diagnosis-Related Groups (MS-DRG), and more. Understand major proposals and their potential impact and how to provide feedback to CMS.
Certain provider services such as acupuncture and cosmetic surgery are not reimbursed by Medicare. This article describes when and how to apply HCPCS modifiers for non-covered services.
Facilities can limit their exposure to claim denials and external reviews by implementing a robust internal coding compliance program. This article breaks down components of a coding policy and compliance plan and approaches to monitoring coding quality.
Anxiety disorders are the most common mental illness in the U.S., according to the National Institute of Mental Health Statistics. Shelley Safian, PhD, RHIA, CCS-P, COC, CIC, breaks down ICD-10-CM coding for common types of anxiety disorders and psychotherapy treatments used to manage them.
The 2022 ICD-10-CM manual includes new codes for thrombotic microangiopathy (TMA)—a rare clinical syndrome defined by the presence of hemolytic anemia, organ dysfunction, and low platelets. Read up on TMA pathophysiology and diagnosis coding.
Chapter 19 of ICD-10-CM includes codes for various types of injuries, poisonings, and other consequences of external causes. Review integumentary anatomy and ICD-10-CM coding for burns and superficial injuries.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, breaks down CPT coding for subsequent hospital visits and services provided on the day of discharge from inpatient status.
Review documentation requirements and CPT coding for radiology services including computed tomography and x-ray scans, breast mammography, and bone length studies.
Fundamentally, what makes outpatient CDI different from inpatient CDI? A multitude of similarities exist between inpatient CDI basics and reviews, but outpatient CDI has many different areas of opportunity.
Although many provisions of the 2022 Outpatient Prospective Payment System (OPPS) final rule are a light lift for hospitals, several have far-reaching implications. Apply these expert tips to ensure you're up to speed and aware of compliance pitfalls.
