When I was a physician advisor, our system had a malnutrition crisis. It wasn’t that we had an explosion of unexpected cases; we were not
If there is no organ dysfunction, it is not sepsis. EDITOR’S NOTE: Dr. Erica Remer reported this story live during the Sept. 10 edition of Talk
The author reports on the recent court decision to dismiss a False Claims Act lawsuit against Dallas-based Baylor, Scott & White Health. EDITOR’S NOTE: Dr.
Wrapping your brain around Cerebral Edema You may be noticing an uptick in clinical validation denials for cerebral edema. Here’s my take on this. There
CDISs urged to be prepared for changes. There is much to do on listserves and various conversations with colleagues to be had regarding the Centers
The public comment period ends June 24, 2019 on the CMS proposed changes to CCs and MCCs. The Centers for Medicare & Medicaid Services (CMS)
When efficiency is not truly efficient, after all. “Efficiency” may be defined in many ways, including the following, as described by dictionary.com: Able to accomplish
Understanding the correct use of chronic condition codes in the coding process. Coders are often confused regarding when they should code co-morbid chronic conditions and
The clinical query process is a small yet important part of any CDI initiative. By now I am confident that most in the clinical documentation
The authors discusses the lawsuit against Providence St. Joseph Health Services for alleged upcoding. Performance with a purpose must be the driving force for business
A CDIS recently posed a question that baffled – to say the least. In my consulting practice, I often review provider documentation to identify documentation
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.
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.
Why should you be focused on SDOH data and ICD-10-CM Z codes? How can you integrate the capture of these elements into your workflows? Get guidance now — before new CMS assessment and reporting mandates take effect.
Set yourself up for appeal success with knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, the challenges clinical teams face, and how to write a concise and compliant validation query.
Gain a clear understanding of the documentation issues that can sabotage reimbursement for payment hierarchical condition categories (HCCs) and how you can mitigate your risks with a strong CDI program.
What are the changes to the IPO and ACS lists for 2023? What auditor trends do you need to watch out for in the new year? Don’t be caught off guard. Register today for this essential regulatory update led by Dr. Ronald Hirsch.
Take away tried-and-true strategies for ensuring that your Utilization Review committee is working effectively
A massive task lies ahead! Now’s the time to start preparing your case management and utilization review teams for successful implementation of changes contained in the 2023 IPPS, OPPS and MPFS rules.
Learn how to achieve complete, accurate documentation that establishes medical necessity and how to differentiate between billable and non-billable services.
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