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TEAM HARMONY BLOG
OIG Report Uncovers Potential Fraudulent Payments for High-Risk Diagnoses
The October 2024 Report on Health Risk Assessments from the Office of Inspector General (OIG) uncovered potential fraudulent payments for high-risk diagnoses. Health Risk Assessments (HRAs) are utilized as part of the Annual Wellness Visit with a healthcare professional. HRAs are intended as a self-reported assessment included in the reconciliation during office, home, and telemedicine visits. Their purpose is to support providers in developing prevention plans to improve health status and delay the onset of chronic disease. Concerns Arise from New OIG Report In the OIG’s Office of Evaluation and Inspections report, concerns were raised about: The appropriateness of risk-adjusted…
WEBINAR: 2025 CM/PCS Changes for ICD-10
Calling all IP/OP coders! Please join us for a free Webinar surrounding the 2025 CM/PCS Changes for ICD-10. Attendees will learn about relevant guidelines changes, new codes, and pertinent note updates. Discover the new ICD-10-CM codes that cover obesity, hypoglycemic levels, pulmonary embolisms, and fistulas. The ICD-10-PCS component will cover lymphatic bypass procedures, new breast reconstruction procedure, two new filtration procedures, among other topics. Take 90 minutes to explore these code updates in advance of the October 1st effective date. Learning Objectives: Recognize new guideline changes Learn new codes Understand pertinent note updates Discover new ICD-10-CM codes covering: Obesity Hypoglycemic…
Community Hospital Captures Millions of Revenue, Avoids Compliance Issues With Harmony Staffing
A California hospital was missing out on millions of dollars in uncaptured revenue while risking audits and penalties for compliance issues. Challenge At a community hospital in California with a high Medicare population, an underperforming and understaffed Inpatient Clinical Documentation Integrity (CDI) team was reviewing less than 50% of Medicare discharges – with some months being as low as 25%. The hospital’s Health Information (HIM) leadership faced a dilemma. The understaffed CDI department lacked the bandwidth to capture the revenue necessary to support budgeting for more CDI staff. At the same time, the area’s high cost of living meant finding…
