September 20, 2018
Emergency Preparedness 101: Going Beyond “Process and Roll”
Accounting for socioeconomic factors is critical to the sustainability of healthcare. Editor’s Note: This article was written as Hurricane Florence was heading directly for the United States’ East Coast. Stores from the Georgia to Delaware have barren shelves where staples, as water and toilet paper are usually stocked. Nature and…
September 13, 2018
Hurricane Florence: Lessons Learned for HIM Professionals
HIM professionals are offered advice for hurricane preparedness. EDITOR’S NOTE: At press time, Hurricane Florence, described as an “extremely dangerous” Category 4 hurricane, was headed for the southern North Carolina coast. In a written statement to RACmonitor, Atrium Health, formerly Carolinas Healthcare System, said that its teams “remain focused on…
September 6, 2018
CMS’s Proposed E&M Coding Changes – and the Rest of the Story
The proposed documentation changes will require retraining an entire industry. EDITOR’S NOTE: The public comment period for the 2019 proposed MPFS closes Monday, Sept. 10, 2018. The 2019 proposed Medicare Physician Fee Schedule has clearly articulated the Centers for Medicare & Medicaid (CMS) goal of “patients over paperwork.” I think…
May 24, 2018
New Z Codes Include Code for Millennials
New Z codes also aimed at reducing hospital readmissions. The one thing that medicine does not have enough of is abbreviations. So allow me to introduce the RACmonitor audience to another one: SDoH. I am sure many of you are aware of the social determinants of health (SdoH), but for…
March 8, 2018
Top Audit Finding: Discrepancies in Secondary Diagnosis Assignment on Outpatient and Pro-Fee Claims
There is no need to worry about coding for HCCs or risk adjustment, writes the author. Just follow the coding guidelines. Confusion abounds regarding the application of Section IV ICD-10-CM Coding Guidelines. And while hospital outpatient coders may be more programmed to code additional diagnoses, physician pro-fee coders may just…
October 27, 2017
Novitas Guidelines for Malnutrition Reported to be Outdated, not Useful for Physicians
Release of outdate guidelines raises fears that other MACs might adopt them to audit providers. The use of outdated definitions of malnutrition by a Medicare Administrative Contractor (MAC) is raising concerns that other MACs may adopt the same flawed practice. The universally accepted definitions, known as the American Society for…
August 10, 2017
IRF 2018 Final Rule: Noteworthy or Calm Before the Storm?
The Inpatient Rehabilitation Facility (IRF) Prospective Payment System Final Rule for the 2018 fiscal year was published Aug. 3, 2017 without any major changes in policy and with the expected minimal updates to payment. Some key provisions of the Final Rule include the following. Specifically, it: Updates the federal prospective…
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Allen Jost, PhDAlvin Gore, MD, CHCQM and Cathi Charlberg, LVN, CHCQMAmanda Gilliland, RN, BSNAndrew B. Wachler, Esq.Andrew H. Hughes, MD and Charles Locke, MD, CHCQM-PHYADVAndrew Wachler and Kaitlin NucciAndrew Wachler, Esq., and Sarah Hillegonds, Esq.Angela Phillips, PTBarbara Vandegrift, RN, BSN, MABecky Rodrian, CPC, CEMC, CBCS, MBSBrian T. LandryChristina Panos, RHIA, CTRChristopher Halleman, DOChristopher J. Laney, Esq.Chuck BuckDaniel Zirkman, MDDavid M. Glaser, Esq.Denise Nash, MD, CCS, CIMDheeraj Mahajan, MD, FACPDuane Abbey, PhD, CFPEdward Roche, PhD, JDElizabeth C. Dunbar, MD, MBA, FACEP, CHCQM-PHYADVEllen Fink-Samnick MSW, ACSW, LCSW, CCM, CRPErica E. Remer, MD, FACEP, CCDSErin Diesel Roumayah, Esq.Frank D. Cohen, MPA, MBBGlenn Krauss, RHIA, BBA, CCS, CCS-P, CPUR, CCDS, C-CDI, PCS, FCS, C-CDAMGloryanne Bryant, RHIA, RHIT, CCS, CCDSGreg FordHolly Louie, RN, CHBMEJ. Paul Spencer, CPC, COCJanelle Ali-Dinar, PhDJeffrey D. Lehrman DPM, FASPS, MAPWCAJessica Forster, Esq.John K. Hall, MD, JD, MBA, FCLM, FRCPCJuliet B. Ugarte Hopkins, MD, CHCQM-PHYADVKathleen K. Borchard, BSN, RN-ACMKathy Seward, MD, CHCQM-PHYADVKim T. Charland, BA, RHIT, CCSKnicole C. Emanuel Esq.Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-approved ICD-10-CM/PCS trainerLaurie M. Johnson, MS, RHIA, FAHIMALori O’Hara, MA, CCC-SLPMark SpiveyMarvin D Mitchell, RN, BSN, MBAMary Beth Pace, RN, BSN, MBA, ACM, CMACMary Inman, Esq. and Max Voldman, Esq.Matthew AlbrightMax Voldman, Esq.Melinda Battaile, MD, FHM, MMCI, CHCQM-PHYADV, CCDSMichael A. Salvatore, MD, FACPMichael Rosen, Esq.
