The ICD-10-CM is so granular that it has been described as needlessly specific, absurd, and unnecessarily detailed. Some argue that this seemingly excessive detail, in theory, allows for more accurate labeling of diagnoses required both for billing and observational analysis.

The Centers for Medicare & Medicaid Services (CMS) recently made significant changes in its statistical sampling methodology for overpayment estimation. Effective Jan. 2, 2019, CMS radically changed its guidance on the use of extrapolation in audits by...

Valerie Watzlaf, 2019 American Health Information Management Association (AHIMA) President and Chair, was a guest on the most recent Talk Ten Tuesdays broadcast. Here are her remarks from that broadcast.

Starting October 1, skilled nursing facility operators will have no choice but to become proficient with a specific type of medical coding that previously had no bearing on reimbursements — and leading industry voices say there are multiple paths to getting there.

I have always been convinced of the strong capabilities of current clinical documentation integrity (CDI) initiatives to achieve tremendous improvement in the completeness and quality of documentation and communication of patient care in the electronic health record.

Effective Jan. 2, 2019, the Centers for Medicare & Medicaid Services (CMS) radically changed its guidance on the use of extrapolation in audits by Recovery Audit Contractors (RACs), Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors...