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…

Are Your Provider Claim Submissions Fraudulent?
Robust Outpatient Clinical Documentation Integrity (OP CDI) programs include establishing policies designed to review select diagnoses that the Office of Inspector General (OIG) has determined to have been historically overpaid. By establishing a policy to review these diagnoses, denials will be minimized, and institutions and providers will be less exposed to potential fines from inaccurate claim submissions. In addition, pre-bill reviews will provide an additional means for provider education targeting suspect providers to cease future inaccurate coding, while at the same time, contribute to the impact as a result of accurate documentation practices. Bombshell Report Leads to Increased Diagnoses Scrutiny…