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The Controversy Continues: Medical Necessity versus MDM

“Medical necessity” is a much-used but often-misunderstood concept. After our recent four-part series on the “Pitfalls of an Audit” and our last Talk Ten Tuesdays segment on the series, I

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Why Most CDI Programs Fail to Engage Physicians

CDI programs are viewed by most physicians as hospital-led initiatives geared towards increasing reimbursement for the hospital.The majority of clinical documentation improvement (CDI) programs fail to effectively engage physicians as

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Good News, Bad News: The Saga Continues

The long-awaited update to the CT lung screening national coverage determination (NCD) was finally released this month. As you may recall, current smokers who were otherwise eligible were omitted from

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Chronic Traumatic Encephalopathy (CTE) and ICD-10

In December, the movie “Concussion” was released.  It tells the intriguing story of an investigation into repetitive concussion injuries and the National Football League (NFL).

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ICD-10: Some Challenges Remain

Although ICD-10 implementation has gone amazingly well, there are specialty-specific challenges arising for some practices and groups. For example, orthopedics has an incredibly large list of extremely specific codes. That can be

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