The time a patient spends in observation status—that is being observed by a physician pending a decision to admit or discharge the patient—doesn’t count toward the minimum qualifying time required to transfer the patient to a skilled nursing facility (SNF),...Read More »
Q: With electronic health records, many times the attending provider will “pull” the pathology or radiology report into their note and sign the note. What further documentation would be needed in order to code from this, which is now part of the attending provider’s note but was...Read More »
The third annual CDI Week celebration was a tremendous success. More than 2,000 individuals registered for our free webinars, breaking records with our platform vendor!Read More »
At least a few members of Congress heard the complaints of constituents regarding the “2-Midnight” rule included in the 2014 IPPS Final Rule, and more than 100 House Representatives signed a letter to CMS urging the agency to delay the rule by at least six...Read More »
In two recent findings from the Office of the Inspector General (OIG), improper documentation may have led to inaccurate claims submission and associated payments....Read More »
There are many articles about the enhanced documentation required in ICD-10-CM. However, the real challenge will be ICD-10-PCS. It is a completely new code set and is not used in any other country than our own. ICD-10-PCS does not include...Read More »
CMS has been releasing ICD-10 National Coverage Determination (NCD) “omnibus” transmittals since September 2012, which gives providers some information about CMS’ coverage policies moving forward. NCDs are only part of the picture. On September 6, CMS...Read More »
