ICD-10

CMS Ups Reimbursement For Certain SDOH Codes

By Amanda Norris for Health Leaders Media CMS recently released the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) final rule. Along with its yearly payment rate changes, the final rule placed a focus on promoting high-quality care and rewarding hospitals that deliver such care to underserved populations. Notably, CMS finalized a higher severity level designation for…

Read MoreCMS Ups Reimbursement For Certain SDOH Codes

CDC Releases New Diagnosis Codes for 2023 With a Focus on SDOH

By Amanda Norris for Health Leaders The CDC just released upcoming changes to both the ICD-10-CM diagnosis code set and the official coding guidelines. The new changes include 42 diagnosis code additions, seven deletions, and one code revision. All changes will go into effect April 1, which should give revenue cycle leaders time to train staff and…

Read MoreCDC Releases New Diagnosis Codes for 2023 With a Focus on SDOH

Revenue Cycle Management is Top Software Investment Priority for Providers

By Jay Asser for Health Leaders Coming off the heels of the COVID-19 pandemic, providers are doubling down on software investments and prioritizing revenue cycle management to alleviate macroeconomic challenges, according to a report from Bain & Company and KLAS. The research finds that 45% of providers accelerated software investment over the past year, with 10% pulling…

Read MoreRevenue Cycle Management is Top Software Investment Priority for Providers

AMA Announces CPT update for COVID-19 boosters adapted to omicron

From AMA CHICAGO — The American Medical Association (AMA) today announced an editorial update to Current Procedural Terminology (CPT)®, the nation’s leading medical terminology code set for describing health care procedures and services, that includes eight new codes for the bivalent COVID-19 vaccine booster doses from Moderna and Pfizer-BioNTech. The updated boosters are adapted for the…

Read MoreAMA Announces CPT update for COVID-19 boosters adapted to omicron

AMA Announces CPT Update for Pediatric COVID-19 Vaccine Candidate

From For the Record The American Medical Association (AMA) recently announced an editorial update to CPT, the nation’s leading medical terminology code set for describing health care procedures and services, that includes new product and administration codes assigned to the Moderna COVID-19 vaccine for children 6 months through 5 years old. The provisional CPT codes are…

Read MoreAMA Announces CPT Update for Pediatric COVID-19 Vaccine Candidate

Internal Audits Help Combat Payer Risk

By Dawn Crump, MA, CHC, SSBB for For the Record Wonder Woman has a golden lasso. Captain America has an impenetrable shield. Thor has a lightning hammer. Just as these magical tools bolster superheroes’ defenses, insights gleaned from internal audits are your organization’s superpower to prevent revenue recoupment and drive down risk. Audits identify revenue…

Read MoreInternal Audits Help Combat Payer Risk

Social determinants of health and medical coding: What to know

Andeis Robezienks for AMA Recognition of the impact that social determinants of health (SDOH) have on patients’ outcomes is growing, as is the desire to incorporate SDOH factors into patient-care plans. But awareness of an existing data infrastructure that could help physician practices do so is limited. “The clinical care we provide only accounts for…

Read MoreSocial determinants of health and medical coding: What to know

CMS proposes 1,495 changes to ICD-10 diagnosis codes

By Alia Paavlov for Becker’s Hospital Review CMS proposed 1,495 changes to the ICD-10-CM diagnostic code set in its proposed Inpatient Prospective Payment System rule released April 18. A large slew of the proposed changes focus on brain illness and injuries — mostly dementia-related diagnoses  — and endometriosis. Specifically, CMS proposed a set of codes that focus…

Read MoreCMS proposes 1,495 changes to ICD-10 diagnosis codes

CMS creates billing codes for treatment found effective against omicron

By Alia Paavola for Becker’s Hospital Review CMS released its Medicare payment codes for administering an antibody treatment found effective against the COVID-19 omicron variant. The payment codes, effective Feb. 11, are for bebtelovimab. The drug was authorized last week by the FDA to treat patients who are at high risk for progression to severe…

Read MoreCMS creates billing codes for treatment found effective against omicron