Denials have been on my mind for the last few weeks – specifically, how do we prevent them? According to the Public Broadcasting Service (PBS),
35 countries have formally adopted the new code set. In February of 2022, the World Health Organization (WHO) released the first official version of ICD-11.
Skyrocketing rates of improper payments have coincided with historically rapid enrollment in the MA program. It was a Centers for Medicare & Medicaid Services (CMS)
It may become common practice to identify genetic abnormalities prior to the development of manifestations. Any of you who know me know that I wholeheartedly
The naming of drugs is a curious matter. My husband had an unconventional friend who let his cat pick his first kid’s name. He wrote
Over the years, computer-assisted coding (CAC) has proven its ability to boost revenue team productivity and accelerate critical decision-making while reducing denials, missed charges, and
Your facility coding guidelines should be clear as to what information may be used to determine SDoH codes. Many payers are utilizing data for the
Predicting coding patterns using the HCC risk scores can be a valuable endeavor. EDITOR’S NOTE: Longtime RACmonitor contributing correspondent Frank Cohen, a senior healthcare analyst,
Workflow increases productivity, while proving itself to be successful in reconciling DRG mismatches. When asking many clinical documentation improvement specialists (CDISs) what they dislike most
The new code set could be implemented in the U.S. as early as 2023. It may be a while before the U.S. implements ICD-11 for
The following is a refresher on terminologies and coding systems in healthcare. There are various terminologies and coding systems used in healthcare, and this article
New code becomes effective Oct. 1, 2022. I participated in the development of a diagnosis proposal on PTEN Hamartoma Tumor Syndrome for the Coordination and
Dr. Ronald Hirsch provides tried-and-true strategies and insight into outpatient in hospital bed stays including determining the applicable definition, who uses it, and when and how to bill for this circumstance, solidified with concrete case examples and expert insight.
Practical solutions for CDM departments to protect your hospital’s revenue.
This webcast teaches hospitals how to comply with CMS price transparency rules and compare their rates with peer hospitals. It covers creating a compliant machine-readable file, comparing negotiated rates, and improving pricing decisions.
The No Surprises Act (NSA) presents a challenge for hospitals and providers who must provide Good Faith Estimates (GFEs) for all schedulable services for self-pay and uninsured patients. Compliance is necessary, but few hospitals have been able to fully comply with the requirements despite being a year into the NSA. This webcast provides an overview of the NSA/GFE policy, its impact, and a step-by-step process to adhere to the requirements and avoid non-compliance penalties.
This expert-guided webcast will showcase tips for providers to ensure appropriate capture of the work performed for a visit. Comprehensive examples will be given that demonstrate documentation gaps and how to educate providers on the documentation necessary to appropriately assign a level of service. You will gain clarification on answers regarding emergency department and urgent care coding circumstances as well as a review of how/when it is appropriate to code for E&M in radiology and more.
Set yourself up for financial and compliance success with expert guidance that breaks down the impactful changes including MS-DRG methodology, surgical hierarchy updates, and many new technology add-on payments (NTAPs). Identify areas of potential challenge ahead of time and master solutions for all 2024 Proposed IPPS changes.
Do you struggle with selecting and appending the correct modifier for your medical claims? Join our must-attend webinar, “Mastering Modifier Usage: Preventing Denials and Ensuring Compliance” to reduce claim denials and improve your reimbursement rates.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2023 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Get access to important guidance on each of the AHA‘s 2023 ICD-10-CM/PCS Quarterly Coding Clinics with information-packed on-demand webcasts available shortly after each official publication.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s third quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Kay Piper reviews the guidance and updates coders on information in the AHA’s second quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s first quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Familiarize yourself with the dramatic 2023 changes to codes, coding guidelines and documentation requirements for evaluation and management (E&M) split/shared and incident-to services.
Dr. Ronald Hirsch breaks down significant 2023 changes to coding and billing requirements for hospital observation services, including new physician E&M coding rules.
Learn how to save your facility hundreds of thousands of dollars in repayments and fines by correctly following CMS requirements for implantable medical device credit reporting. We provide you with all the need-to-know protocols, along with the steps for correct compliance while offering best practices to implement a viable strategy in your facility.
During an exclusive RACmonitor webcast, healthcare attorney Knicole Emanuel will explain in simple, easy-to-understand language the peril of the coming overpayment audits and describe your legal defenses.
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