Coding Diabetes: Time to Look at the Coding Guidelines Again
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During November, the Centers for Medicare & Medicaid Services (CMS) is raising awareness about diabetes, diabetic eye disease, the importance of early disease detection, and related preventive health services covered by Medicare. According to the CMS website, diabetes can lead to severe complications such
as...
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Hospitals, Systems Spend $39B Annually on Regulatory Compliance
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Conditions of participation, medical billing, and coverage verification's topped the list of costliest regulatory compliance categories, an AHA study showed.
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The Hidden Tragedy of the Opioid Crisis
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When President Trump declared the opioid crisis a public health emergency Thursday, he noted that "last year we lost at least 64,000 Americans to overdoses." He is not incorrect. A preliminary analysis for 2016 from the Centers for Disease Control and Prevention estimated the toll
at...
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Nursing Shortage Hits Crisis Levels
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A shortage of experienced nurses has hit the United States, particularly in rural communities, forcing many hospitals in the Midwest to recruit nurses from one another. One way hospitals have tried to alleviate the crisis is by using foreign nurses to fill the gap. But it can take years for nurses to
obtain...
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CMS Publishes RADV Medical Reviewer Guidance |
In the Medicare Advantage (MA) context, "risk adjustment" is the process by which the Centers for Medicare & Medicaid Services (CMS) reimburses Medicare Advantage Organizations (MAOs) based on demographic factors and the health status of enrolled members. By regulation, MAOs must
submit...
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