After decades of development, endless regulatory hurdles and multiple delays, the implementation date for ICD-10 has arrived. If ICD-10 had a theme song, it certainly would be “The Long and […]

A system for classifying knowledge is a framework for organizing information. It is usually a vastly simplified model of some aspect of reality as we understand it, like the periodic […]

Back in March, I reported at the CMS ICD-10 Coordination and Maintenance meeting that the expected financial impact of the conversion to ICD-10 for a typical Medicare inpatient case mix […]

Did you end up here because you haven’t done squat about ICD-10, and you googled “ICD-10 cheat sheet?” Fantastic. Come on in, there’s plenty of room. I could get all […]

So there are PPCs and HACs, PPRs and PPAs, PSIs and VBP just to name a few. But please don’t forget or underestimate the importance of HCCs. Why should you […]

If you have the slightest inclination to freak out about ICD-10 because change makes you nervous, please ignore this blog. Okay, now for the rest of you: the code sets […]

I hope the publication of the 2016 OPPS proposed rule on July 1st did not dampen anyone’s July 4th celebration. The new rule continues the migration CMS began in 2014 […]

In past blogs, I’ve written about a variety of E&M services and how to code those visits. In case that seemed straightforward, many years ago mid-level providers were added into […]

No one likes surprises, especially when it comes to financial performance. In order to reduce unexpected results, many hospitals and payers have decided to address the issue up front. You […]

Last week, The Journal of the American Medical Association (JAMA) published the results of a study that showed that the Pioneer Accountable Care Organization (ACO) Model achieved almost $400 million […]

Thirty-eight states are developing State Innovation Models (SIM), or new models for multi-payer healthcare payment and service delivery, funded by grants from CMS. The SIM program tests ways to lower […]

Last week, CMS published updated I/OCE specifications and software. The changes revolved around calculations of the complexity adjustment for the comprehensive APCs (C-APCs). Bypassing the code pair ranking The specific […]