Establishing an outpatient CDI program can have substantial benefits. Recently, an outpatient CDI review project demonstrated there were many documentation improvement opportunities at a large family practice/internal medicine physician clinic.
Findings from a computational health informatics study recently published in Medical Care Research and Review suggest that provider connectedness is associated with reduced 30-day readmission rates for heart failure patients following hospital discharge.
Experts Richard Pinson, MD, FACP, CCS, and Cynthia Tang, RHIA, CCS review the recently published “Global Leadership Initiative on Malnutrition (GLIM) Criteria for the Diagnosis of Malnutrition: A Consensus Report From the Global Clinical Nutrition Community” and help coders apply this criteria in ICD-10-CM.
The 2019 CPT code update includes 19 code additions and three revisions to the cardiovascular section of the CPT Manual. These changes reflect advances in surgical treatment for cardiovascular conditions such as heart failure and aortic stenosis.
CMS released Transmittal 4188 on December 28, adding instructions to Chapter 23 of the Medicare Claims Processing Manual for the accurate interpretation of claim edits and assignment of modifiers -59 (distinct procedural service) and -91 (repeat clinical diagnostic laboratory test) on Medicare Part B claims.
Despite facing potential lawsuits and political opposition, CMS finalized some of its most controversial proposals in the 2019 OPPS final rule by implementing several site-neutral payment policies and 340B drug payment reductions.
Findings from a retrospective analysis of inpatient data recently published in Critical Care Medicine show that average hospital costs and mortality rates are significantly higher for patients diagnosed with sepsis after hospital admission when compared with patients diagnosed prior to admission.
Along with E/M changes for 2019 and beyond, the 2019 Medicare Physician Fee Schedule final rule contains a plethora of regulations impacting reimbursement, including new modifiers for therapists.
Medicare’s new method of calculating payment rates for laboratory tests, intended to reduce Medicare spending by $360 million in the first year, could cost the agency billions in overpayments, according to a recent report from the U.S. Government Accountability Office.
