With the help of hindsight and data, we can now more accurately predict coding productivity and staffing needs. The run-up to ICD-10 had most of us very concerned, expecting to experience a decline in productivity of as much as 40 percent or more.

The final updated ICD-10-CM codes for 2018, posted on the Centers for Medicare and Medicaid Services’ (CMS) website, contain 360 new, 142 deleted, and 226 revised diagnosis codes, according to a report from HealthLeaders Media. The revisions include 322 more changes...

Carriers are starting to discover that without professional expertise to turn disparate data into actionable optimization and measurable intelligence, data is powerless.

There is a great push within the healthcare industry to move clinical documentation integrity (CDI) into the outpatient arena. People refer to this as “outpatient CDI,” but I think this is a misnomer. If you plan on stationing CDI specialists (CDISs) in physician offices, that could be construed as “outpatient CDI,” but I believe the larger issue is whether we should start tending to conditions even if they are not risk-adjusting in the inpatient realm.

Below are a few basic guidelines about Medicare compliance and some options people have to maintain eligibility after receiving an injury settlement. When is Medicare a “Secondary Payer”?...