In developing our classification tools we are continually called upon to make judgement calls on the relative clinical complexity of individuals and the interaction between comorbid chronic conditions on quality […]
I have always wondered why the reimbursement for services provided at a Provider-Based Clinic (PBC) was higher (often more than 50 percent higher) than the same services provided at a […]
Our recent article, “Implementing a Site-Neutral PPS,” published in the HFMA journal, highlights the potential for a reform currently making its way through the legislative process. The proposed legislation—referred to […]
On September 10, 2015, while most of us in health care were deeply involved in ICD-10 preparation, the Department of Justice (DOJ) released a ruling that will significantly impact every […]
I’ve written in the past about how to score the language within an E&M note. There are a number of ways to arrive at the same code, or in fact, […]
As we all focus on the looming deadline for the ICD-10 go-live, CMS is quietly floating more changes to short stay requirements. CMS reiterated its goals of “respecting the judgment […]
My mother taught me that it’s impolite to say “I told you so.” My daughter tells me I’m bossy and health care compliance is pretty dry (she’s trying not to […]
3M’s Donna Smith explains why the differences can impact a clinical documentation improvement program.
Can HCCs be used to improve patient outcomes? Learn more from 3M’s Donna Smith.
What are the differences between inpatient and outpatient CDI programs? Learn more about the unique documentation challenges facing each type of facility.
The team I work with has done an enormous amount of work translating medical necessity policies from ICD-9 to ICD-10. And we have had many discussions regarding the codes that […]
In past blogs, I’ve written about a variety of E&M services and how to code those visits. In case that seemed straightforward, many years ago mid-level providers were added into […]