Demystifying the Pathogenesis of Sepsis

Published: Mon, 05/22/17

I want to begin with a coding scenario: sepsis and pneumonia are documented, and the coder captures these conditions and assigns MS-DRG 871 and APR-DRG 720 with severity of illness (SOI) 2. Sepsis presents challenges for coders as well as clinicians. I want to provide insight into the complex molecular and cellular processes involved in the pathogenesis of sepsis.

Click Here to Read More

CMS Tackles Opioid Prescribing

The Centers for Medicare & Medicaid Services (CMS) intends to align its Medicare plans, including Part D prescription plans, with the Centers for Disease Control and Prevention (CDC) opioid prescribing guidelines. On January 5, 2017, the agency released a statement justifying this action. Because of “the growing body of evidence on the risks of...

Click Here to Read More

CMS Exempts Two Thirds of Clinicians From MIPS

The Centers for Medicare & Medicaid Services (CMS) has exempted about two thirds of physicians and other clinicians who provide care to Medicare beneficiaries from the Merit-based Incentive Payment System (MIPS), a pay-for-performance scheme that will determine part of physicians' Medicare payments, starting in 2019.

Click Here to Read More

3 Best Practices for Hospital Claim Denials Management

Implementing claim denials management best practices is key to ensuring hospitals maximize claims reimbursement revenue and prevent denials. Healthcare cost control continued to top hospital priority lists in 2017. But hospital leaders may be leaving millions of dollars on the table because of inefficient claim denials management processes.

Click Here to Read More

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...

Click Here to Read More

Registered Health Information Technician

Registered Health Information Administrator

Certified Risk Adjustment Coder Exam Bundle