Experienced coders like myself recall a simpler time when October 1st of each year was THE date when our ICD diagnosis and procedure codes were updated and the DRG system got a fresh new face. For the past few years April 1st has become another important milestone in the coding world, with the introduction of new codes and tweaks to the current MS-DRG system.

On Nov 8th, the HHS and OIG released a revised and renamed Provider Self-Disclosure Protocol (SDP). This is the first revision to the SDP since 2013. Here are our top takeaways from the revised SDP and what you need to know before starting the self-disclosure process.

Did you read the FY2022 IPPS Final Rule? While it’s usually an effective cure for insomnia, there is an interesting tidbit regarding unspecified ICD-10-CM laterality diagnosis codes that may keep you up. Let’s take a deep dive and consider how it impacts our coding world.

2020 brought many changes very quickly across healthcare, most notably in the use of telehealth technology. In January, the OIG amended its 2021 work-plan to include audits of Medicare Part B and home health telehealth services.

As unpleasant as the task may seem, a coding and documentation audit of your healthcare organization is the best kind of medicine to ensure a healthy bottom line for your revenue cycle. If you are not consistently performing audits you could be making the same mistakes over and over.

On December 1, 2020, CMS gifted us with its long awaited 2021 Physician Fee Schedule (PFS), that bundle of regulations that governs physician payments. The good news is that with changes made to E/M documentation and code assignment, primary care providers are likely to see an 11%-15% increase in their Medicare payments. According to CMS Administrator Seema Verma, the increases are supportive of “clinicians who manage the ongoing care of patients with a host of chronic diseases, or patient transition between hospitals, nursing facilities, and home.” Alas, there is bad news as well.

CMS released its annual update to the Inpatient Prospective Payment System on September 2, 2020.  The new rule takes effect on October 1, 2020.  While the rule is a whopping 2160 pages long, MRS has done the research and here are the key points coders need to know.

Tis the season. Your patients will be lining up for their annual flu shots and pneumonia immunizations. Knowing how to code and bill these services correctly will save you time and headaches.

On August 17 CMS published updated payment information regarding COVID-19 policies for acute care hospitals, long-term care hospitals, and inpatient rehabilitation facilities. The update specifically addresses implementation of Sections 3710 and 3711 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Providers, unfortunately, do not always document as thoroughly as they should. How do we help our providers improve their documentation skills?

Did you know that as part of the Affordable Care Act, any provider who treats Medicare and Medicaid beneficiaries is required to establish a compliance program?

Consistent accurate outpatient coding has become increasingly important in recent years, particularly in light of the outpatient risk stratifying system known as Hierarchical Condition Categories.

If you are not consistently performing coding audits in your organization, you could be making the same coding mistakes over and over.