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Coding for meaningful data: ICD-10-PCS root operations

May 24th, 2017 / By Rhonda Butler

Root operations are core concepts at the heart of the ICD-10-PCS classification (PCS for short). Root operations are not created equal—some are more narrowly defined than others. It would be […]

Answer four key questions to transform report data into actionable data

May 22nd, 2017 / By Kristine Daynes

The digital age has created more noise than useful information. This is especially true in health care, where the quantity of electronic health information has exploded over the past decade. […]

Coding with Modifiers, Part 1: Modifier 24 made easy

May 19th, 2017 / By Camille Ruiz, RHIA

My colleagues and I were discussing the idea that modifiers have the most room for interpretation by professional fee coders, prompting a three-part blog series covering modifiers 24, 25 and […]

The experience is the differentiator

May 17th, 2017 / By Andy Vitale

By 2020, customer experience will overtake price and product as the key brand differentiator. This is due, largely in part, to the fact that the role of the customer has changed from isolated to connected, from unaware to informed, from passive to active. Customers have access to unprecedented amounts of information, often at their fingertips, allowing them to […]

Outpatient CDI: Substance and mental health disorders

May 15th, 2017 / By Camille Ruiz, RHIA

May is Mental Health month. It is a reminder to revisit outpatient CDI for substance disorders and mental health disorders. The Agency for Healthcare Research and Quality (AHRQ) statistics indicate […]

Getting at quality: What’s involved in knowing the difference between appropriate and inappropriate care

May 12th, 2017 / By L. Gordon Moore, MD

Implantable cardioverter-defibrillators (ICDs) can save a person’s life when they detect a dangerous heart rhythm and correct it by delivering a shock to the heart. For another person it might […]

Spring clean your CDI workflow

May 10th, 2017 / By Cheryl Manchenton

Is your CDI program in a rut? Has your performance plateaued or even diminished? Maybe your program has a case of the “same-ole-itis,” otherwise known as “the way we have always done it” disease. In the words of the song from the musical Auntie Mame,* “Open a new window, open a new door!”

Changes to CPT coding for sedation

May 8th, 2017 / By Rebecca Caux-Harry

The CPT changes for 2017 brought a surprise, at least for me. You may have noticed a trend over the last several years of consolidation within the codeset. When two […]

Engaging the prescriber and the PCP in controlling pharmacy costs

May 5th, 2017 / By Steve Delaronde

Sovaldi is a prescription drug that was approved by the FDA in December 2013 to treat Hepatitis C. The following year, the total cost of prescription drugs in the United […]

Value-based payment means risk adjustment for effective revenue cycle management

May 3rd, 2017 / By Kristine Daynes

Value-based payment models are attracting attention for risk adjustment methodologies, especially HCC risk adjustment, which is used to calculate cost benchmarks for Medicare Advantage and other CMS payment models including […]

HIMagine That: The problem list is a problem

May 1st, 2017 / By Donna Smith, RHIA, Sue Belley, RHIA

Donna: Hi, Sue! Do you ever see something on a problem list that isn’t correct? Sue: Yes, often!  You know I always say, “The problem list is a problem.” Donna: […]

Important coding update from CMS: New mandated reporting for Global Surgical Values

April 28th, 2017 / By Barbara Aubry, RN

This month, I had planned to share some good news on population health, but that will have to wait until next month. I literally just got off a call with […]