RACs can easily data-mine for noncompliance related to coding for ventilator support, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, independent revenue cycle consultant in Madison, WI. For example, patients whose length of stay is fewer than two days can’t...Read More »
by Glenn Krauss, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS
Because most CMS local and national coverage determinations governing medical necessity and limitations of coverage center around outpatient procedures (e.g., lesion removals, cataract surgeries, and blepharoplasty repairs),...Read More »
While the bulk of discussion regarding how to ethically and responsibly submit queries to physicians revolves around releases from the American Health Information Management Association (AHIMA) releases, don’t discount advice from other potential sources. For example,...Read More »
ACDIS Associate Editorial Director Linnea Archibald sends out “missed connections” emails with questions from Council members on a regular basis. Anyone with experience related to one of the questions was invited to respond and Archibald connected them with the question-asker. In order to share...Read More »
Provider-preventable conditions (PPC), including health care-acquired conditions (HCAC), are now subject to payment adjustments under the Medicaid program, according to the final rule released by CMS June 1.
CMS published the 2012 Inpatient Prospective Payment System (IPPS) proposed rule May 5 in the Federal Register. Proposals include changes to MS-DRGs for excisional debridement, a new hospital-...Read More »
Seven U.S. senators believe the Accountable Care Organization (ACO) proposed rule will not only cost more than estimated but will not accomplish the program’s goals. They want CMS to try again.
