How to Report New Code Category W44

One of the goals of medical coding is documenting encounter notes to the highest degree of specificity. ICD-10-CM had some existing codes for documenting foreign bodies entering through a natural…

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AMA issues principles for guiding AI development and use

Amid the rapid growth of what it calls “augmented intelligence” (AI) in health care, the American Medical Association (AMA) has issued a set of principles to channel the technology’s development…

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Hospitals want CMS to correct MA plan policies on coverage

The American Hospital Association is asking the Centers for Medicare and Medicaid Services to crack down on Medicare Advantage insurers it says are blatantly flaunting CMS coverage rules. "We expressed…

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United Healthcare’s Medicare Advantage and the Two-Midnight Rule

Well, I suppose I have given you enough of a break from my writing about Medicare Advantage (MA) plans and the Two-Midnight Rule. Last week, United HealthCare (UHC) released its…

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Beware: Recent Changes to MDS Could Cause Audits

Recent changes to the minimum data set (MDS) assessment and recent audit activity targeting skilled nursing facilities (SNFs) appear to be an emerging issue.  As a reminder, the MDS assessment…

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Feds propose rule changes for No Surprises Act

Federal policy makers aim to revise the billing dispute resolution process in the No Surprises Act (NSA). The administration of President Joe Biden and the U.S. Departments of Health and…

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CMS Says Post-Acute Care Choice Only Goes So Far

Access to post-acute care remains an issue in most hospitals around the country. Exacerbated by the staffing challenges that worsened during COVID-19, the ability to get a patient transferred to…

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Staying Current with Medical Necessity

A new quarter began on Oct. 1, an event that usually brings updates to National Coverage Determinations (NCDs). The coding updates included for Oct. 1 are specified in Change Request…

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