CMS now offers an elearning opportunity on the Quality Payment Program (QPP) through the MLN Learning Management System. This course is the fifth in a growing curriculum on the QPP and will offer 0.5 AMA PRA Category 1 Credits.
Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
On October 4, CMS issued a notice in the Federal Register containing numerous corrections to the 2018 IPPS final rule, including significant recalculations of MS-DRG relative weights and all budget neutrality factors.
My experience in ICD-10-CM documentation and coding integrity is that many physicians know in their heads what is wrong with their patients; however, they have not been taught to “think with ink” in describing their patients' illness in the EHR using ICD-10-CM’s language to ensure proper coding.
Patient care continues to move from the inpatient setting to outpatient. With this change, the challenge of securing comprehensive documentation that articulates the services rendered and the patient care provided now needs to extend across the care continuum.
Outsourcing some HIM functions is common at many organizations. The decision might initially be spurred by staffing shortages or budgetary concerns, but many outsourcing arrangements become long-term projects.
The new ICD-10-CM codes for FY 2018, effective October 1, represent significant changes in our documentation and coding practices. Let’s discuss some of these new codes and their potential impact upon your diagnostic decision-making and documentation.
In a rare bipartisan effort from Congress, 228 members of the House of Representatives urged CMS to abandon a proposal from the 2018 OPPS proposed rule which would drastically cut payments for hospitals participating in the 340B drug discount program.
