The shift of the U.S. health care system from fee for service (FFS) to value-based care and payment now seems inevitable. To date, the transition has been relatively slow, as […]

The March ICD-10 Coordination and Maintenance Committee (C&M) meeting, held via Zoom March 8 and 9, had 60 topics on the combined agenda—29 topics for proposed changes to the procedure […]

As a clinical documentation integrity (CDI) and coding professional, I’ve often heard the statement: If it’s not documented, it wasn’t done. I have used this statement educating physicians and nurses […]

As I hopped on an Amtrak train to go to a meeting (something I haven’t done in a long time!), I pulled out my laptop to start reading emails – […]

I sat down with 3M Health Information Systems Global Chief Medical Officer Sandeep Wadhwa, MD, MBA, to discuss clinical and financial risk management, and risk stratification with Medicare Advantage plans. […]

In December I posted a blog on the “new and improved normal,” discussing the April 1 ICD-10-CM/PCS update added to the schedule beginning in 2022. Two updates a year instead […]

Last year, the Centers for Medicare & Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) jointly finalized a proposal to make the April 1 update of ICD-10-CM/PCS […]

The latest ICD-10 Coordination and Maintenance Committee (C&M) was held virtually Sept. 14-15. First on the agenda, the Centers for Medicare and Medicaid Services (CMS) announced its final joint decision […]

I sat down with 3M Health Information Systems Global Chief Medical Officer Sandeep Wadhwa, MD, MBA, to discuss CMS’ latest guidance on Z codes, SDoH and how that will impact […]

The first draft of this blog was an exhaustive (and exhausting) summary of the actual changes to the FY 2022 ICD-10-PCS posted recently on the Centers for Medicare and Medicaid […]

Hierarchical Condition Categories (HCCs) have been used in the Centers for Medicare & Medicaid Services (CMS) risk adjustment payment model since 2004. That’s 17 years! More and more HIM professionals […]

Some of you may be aware that CMS implemented some add-on payments for COVID-19 high throughput testing effective January 1, 2021. The add-on payments are being implemented to support laboratories […]