The 2016 Rio Olympics: Decoded

This year’s Olympics in Rio have been nothing short of a wild ride – a nail biting roller coaster, for that matter – with the kind of excitement we all come to anticipate from the games. But when you have world-class athletes performing mind-bending feats of strength and agility, it’s pretty much a given that someone’s going to […]

New Rules Gives Providers and Employers Improved Access to Information for Better Patient Care

If there weren’t already enough pressing reasons for accurate and precise documenting and coding in the healthcare world, now enter MACRA. The Medicare Access and CHIP Reauthorization Act, known as MACRA, is the next generation of healthcare legislation. In short, the law (which already is more than 900 pages long) hopes to drive the mass […]

The Shift to Value-Based Care: Technology Will be Key

The healthcare industry is always changing, but there’s been a lot of attention on one major impending evolution in particular – the move from volume (or fee-for-service) to value-based (outcome) payment models. This new wave of the future is something that all healthcare organizations – from major hospital systems to private independent practices – must […]

Training at Your Station

As noted recently on revcycleintelligence.com, multiple mandates of healthcare reform make it imperative that hospitals “have an effective revenue cycle management system in place so they can handle the financial pressures that come from regulation.” Still, according to the article, not all are prepared. Reasons include a lack of staff training across the revenue cycle. It […]

CMS Announces New Excluded ICD-9-CM and ICD-10-CM Diagnosis Codes

The Centers for Medicare and Medicaid Services (CMS) released an alert last week regarding newly excluded ICD diagnosis codes. According to the statement, diagnosis code 999.9 (other and unspecified complications of medical care, not elsewhere classified) will be added to the list of excluded ICD-9-CM diagnosis codes and will no longer be accepted by CMS […]

Why CDI is Important – in Six Figures

Yikes! According to the Office of Inspector General (OIG), a Louisiana hospital incorrectly billed Medicare for claims with a diagnosis of malnutrition (specifically, kwashiorkor), receiving $321,971 in overpayments during a five-year period. As reported on medicarecompliancewatch.com, kwashiorkor, a type of severe protein malnutrition that affects children in subtropical or tropical regions during food shortages, is […]

HIPAA Violations Result in $2.2 Million Settlement

With the complexity and ever-changing nature of healthcare regulations these days, staying on top of the constant changes in, and expansion of, rules and mandates can seem like an overwhelming task. But it’s a critical one for any healthcare organization. Violations of these regulations can have serious financial and legal consequences for everyone involved. Take […]

Changes are coming for ICD-10-CM/PCS for FY 2017

The numbers have been released and they are impressive. Due to a code freeze for several years and the continued need for new or revised codes, there will be thousands of code changes for FY 2017. On March 22, 2016 the Centers for Disease Control and Prevention released the list of diagnosis codes changes for […]

Additional Lessons Available for CDI

Elsevier added 14 lessons in Q1 2016 to its current EduCode Clinical Documentation Improvement curriculum.  These lessons reside in the course titled “Documentation Essentials for Specific Topics, Diagnoses, and Procedures.”  These lessons will be populated on current client sites. The new lessons are listed below:      •  Heart Failure      •  Obstetrics Part 1: Pregnancy      •  Obstetrics Part 2: Labor, […]