Healthcare News
The World Health Organization released the 11th edition of the International Classification of Diseases (ICD). This release was presented at the World Health Assembly on May 25, 2019 for adoption by member states, and will come into effect on January 1, 2022. However, note that it is still unknown when ICD-11 will be ready for implementation in the United States.
Every organization associated with Health Information Coding has felt the pressure to catch everything up at the end of the Fiscal Year. It helps to understand what is at stake and how you can help. Some Fiscal Years (FY) correspond to the calendar year, while others start/end at times established for taxing and accounting purposes. Annual Financial reports are generated during this time to show the success or failure of the organization to meet its goals and expectations.
As we turn the calendar to a new decade, the 2020 CPT code changes take effect. This year there are a total of 394 changes to CPT, bringing the total number of codes to 10,471. This includes 248 new codes, 71 deletions, and 75 code revisions, according to the American Medical Association (AMA). This is Part 1 of a 2-Part Series. In this article, we will discuss the changes in the Surgery Section.
An investigation by the Office of Inspector General (OIG) revealed Medicare Advantage insurers might be overstating patients’ diagnoses without the proper documentation to receive larger payments. Based on the 2016 Medicare Advantage encounter data analyzed by the OIG, insurers were able to get an extra $6.7 billion in payments in 2017.
Medical billing denials generate significant cost for providers and hospitals that could be avoided by improving claims data management and optimizing medical coding processes. Optimal quality coding effectively prevents medical claims denials by reducing the potential for manual error and addressing concerns over fast approaching time limits.
These are 5 common myths of outsourcing, and how YES HIM Consulting debunks these concerns with a skilled team of consultants, coders, and auditors.
Is your medical data at risk? Google just announced a partnership with Ascension, the country’s second-largest hospital system, that will allow the tech giant to store and analyze millions of medical records to improve healthcare services. HIPAA has been amended to include regulations for the safeguarding and sharing of information digitally as new systems have entered the scene…
Locating causes for denied claims can be a tricky process because staff is accustomed to assigning ICD-10-CM diagnosis codes based on the provider’s one major diagnosis documented in the medical record and assume the coding is correct if there isn’t a difference. However, the lack of support for necessity of the bill might not be as obvious.
Revenue Cycle Management can be thought of as the method of transportation to take an organization from one place to where it needs to go. For the transport to occur successfully and be operationally sound, the processes in place to support it must be accurate and deliberate.
Make Room for Exceptions: This years’ updates to the ICD-10-PCS Official Guidelines for Coding and Reporting include a new section, updates to an existing section, new guidance on a body part, some editorial changes and the introduction to the possibility of exceptions for special cases.