November 18, 2016
News & Insights

CMS removed seven codes from the inpatient-only list in the 2017 OPPS final rule, but decided not to change the designation of a code involved with several of the agency’s bundled payment models.  

November 18, 2016
News & Insights

Single-use drug vial wastage and CMS’ implementation of the Quality Payment Program are in the spotlight in the Office of Inspector General’s (OIG) fiscal year 2017 Work Plan. The Work Plan, released November 10, outlines areas the OIG will scrutinize in the coming year and ongoing projects.

November 1, 2016
Briefings on APCs

Orders for services are a vital component of ensuring Medicare coverage. With the advent of computerized provider order entry (CPOE), it is important to review order templates in the electronic medical record (EMR) and the resulting order produced or printed in the formal legal medical record to ensure the templates meet requirements.

November 1, 2016
Briefings on APCs

With only 60 days between the OPPS final rule's release and the January 1 implementation date, providers will be ahead of the curve by spending time now and thinking about the processes they may need to review, change, or implement based on what CMS finalizes and the sort of financial impact the final rule is likely to have.

November 1, 2016
Briefings on APCs

Just like the lyrics to the popular Gap Band song say, "You dropped a bomb on me… I won't forget it," there are definitely some changes in the 2017 ICD-10-CM Official Guidelines for Coding and Reporting that some of us may wish the Cooperating Parties will forget were ever mentioned.

November 8, 2016
Medicare Insider

This week’s Medicare updates include the release of the End-Stage Renal Disease Prospective Payment System final rule, an announcement of the next round of Medicare Recovery Audit Contractors, the Hospital Outpatient Prospective Payment Changes for 2017 final rule, CY 2017 Home Health Prospective Payment System, a Hospital Appeals Settlement Update, and more!

November 4, 2016
News & Insights

Q: Coding Clinic, Third Quarter 2011, p. 4 states:

“…morbid obesity is a chronic condition and; therefore, can be coded as a secondary diagnosis without treatment.” (emphasis added)

An article in the CDI Journal, “From the Forum: Manage denials for BMI morbid obesity,” seems to indicate that providers should document how the obesity affects patient care.

What level of patient care needs to be documented?

November 1, 2016
HIM Briefings

All coders know that working with physicians is not always a positive experience.

It can be tough providing them education or getting responses from queries. Conversely, providers are busy and typically do not like anything to do with coding. When they hear coding they often take that to mean more work on their part.I have been working with providers for many years and the one thing coders always ask me is, 'What is your secret for getting along so well with doctors and engaging them to change behavior?'

Pages