Regulatory compliance reforms have forced CMS to set the bar high for meeting evaluation and management (E/M) standards. This is especially true for clinical documentation improvement (CDI) performance for coding and billing level four and five patient visits in outpatient settings.
Data integrity and analytics, increased HIPAA enforcement, patient-generated health data, and information security emerged as the top four topics at the 2017 Health Information and Management Systems Society national conference.
Effective July 2016, as part of The Joint Commission’s Project REFRESH, the Medical Record Statistics form was retired for hospital accreditation surveys. Is it still important to monitor our medical records for presence, timeliness, legibility (paper or printed), accuracy, authentication, and completeness?
Payment reform is here to stay. Although reimbursement will continue to evolve over the next several years, it’s unlikely that payers, commercial or government, are going to abandon risk-based models and value-based purchasing and turn the clock back to fee-for-service and volume over value.
HIM Briefings’ 2017 EHR benchmark survey took a closer look at EHR implementation and use as well as the role of HIM in EHR management, including common challenges and benefits. Respondents shared experiences, discussed the impact of EHRs on data quality and security, and reflected on HIM’s role in ongoing EHR maintenance.
How we define, diagnose, and document diagnoses that predict morbidity and mortality is essential if we want our patient’s risk to be accurately portrayed.
When it comes to using offshore resources, there are several important compliance requirements HIM professionals need to know. These requirements were created by CMS a decade ago and apply to the use of offshore contractors for all Medicaid, Medicare, and TRICARE patients.
In several recent reports, the Office of Inspector General (OIG) determined that providers are, on average, variant from expected volumes on both short stay inpatient and long stay observation cases. What was not made clear in the OIG report is the reason why it believes such variances exist. The answer to this question likely rests within the details of how hospitals have adjusted (or not adjusted) to the use and application of “new criteria” in their daily and ongoing Medicare billing compliance processes.
This week’s Medicare updates include a revision to State Operations Manual Appendix PP; ICD-10 Coding Revisions to NCDs, clarification of payment policy changes for Negative Pressure Wound Therapy using a disposable device and the outlier payment methodology for home health services; and more!
This week’s Medicare updates include the delay of the effective date of the Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model; a quarterly update to the Medicare Physician Fee Schedule database; ICD-10 coding revisions to National Coverage Determinations; and more!
