Medicare incorrectly paid approximately $1.7 million to Carolinas Medical Center in Charlotte, North Carolina, as a result of incorrect billing on the part of the medical center.Read More »
By Sam Antonios, MD, MMM, FACP, SFHM, CPE, CCDS
Consider the story of a patient—say, a pneumonia patient—whose treatment cost a lot of money. The hospital’s reimbursement for that care, however, was less than the cost of providing it. Now say someone looked at that case and how...Read More »
Much like concurrent CDI reviews, the concurrent coding process necessitates that the coding professional follow the chart throughout the patient’s admission and code it at intervals. The hope is that this process limits the number of clarifications needed after discharge, allowing the...Read More »
Next Thursday, February 15, 1 p.m. eastern, ACDIS members are invited to join the Quarterly Conference Call with the ACDIS Advisory Board to discuss and review the new ACDIS position paper, “...Read More »
Q: What is difference between the severity of illness (SOI)/risk of mortality (ROM) in the APR-DRG arena? For example, DRG 280 with APR 190, 4/4, and the individual code SOI/ROM.
Let’s say you have a patient with a ST-...Read More »
Like all reporting structures, CMS updates its Hierarchical Condition Category (HCC) list each year. Recently, version 23 was released, and it contains some notable additions that CDI professionals—whether inpatient or outpatient—should be aware of.Read More »