Challenging the Six Year Lookback

Published: Wed, 05/10/17

Challenging the Six Year Lookback

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently conducted an audit of Mount Sinai Hospital in New York City. After looking at a sample, the OIG found fault with about...

ICD-10 Coding Questions Answered

One of our physicians is getting conflicting information regarding the ICD-10 codes E66.01 and E66.9. We have been coding E66.9 for Body Mass Indexes (BMIs) between 30-34 and E66.01 for BMIs greater than 35. She has a laminated cheat sheet card that says...

Computer Assisted Coding Anticipated To Grow To $2.5 Billion By 2023

The market for computer-assisted coding grows because it provides management of workflow process value by encouraging increasing efficiency in care delivery for large Professional Physician Practice and Ambulatory Clinical Facility. By making more granular demarcation of diagnoses and care provided for each diagnosis, greater visibility into...

Feds Crack Down on Upcoding

As the totals invested in taking care of the nation's most vulnerable grew, so did the government's efforts to identify fraud and to cut costs. Notable among the cases identified were...
Humana Refines Diabetes Risk Stratification Tool Using ICD-10

The ICD-10 transition provided Humana with the "perfect opportunity" to develop a more detailed diabetes risk stratification tool. In an effort to improve the delivery of targeted chronic disease management services to diabetes patients, Humana has revamped its Diabetes Complications Severity Index (DCSI) risk stratification tool to use ICD-10 codes, the payer detailed in a recent journal article.