Health disparities proven by Medicare claims data during the COVID-19 crisis underscore the need to transition to value-based reimbursement, according to CMS.

HIPAA’s Privacy and Security Rules specify 18 data elements that an individual could use as a means to determine a patient’s identity. The majority of this vulnerable data are easily understood (e.g., name, address, phone number, etc.) and can be applied to nearly any business, however, there are some elements that relate specifically to the healthcare process, including a...

With concerns of COVID-19 having a disproportionate impact on certain individuals, such as minorities and the elderly, public health experts are requiring more detailed data, provided on a real-time basis – further supporting the reliability and integrity of data being central to healthcare.

Being nice can get you in trouble. But as David Glaser, Dr. Ronald Hirsch, and I have said over and over, being nice and putting patient care first should be the excuse during this COVID pandemic for future Recovery Audit Contractor (RAC) and Medicare Administrative Contractor (MAC) audits. We believe that when you err or if you err, err on the side of the patient.

CMS recently released the fiscal year (FY) 2021 ICD-10-PCS code set, which includes 544 new codes for Fragmentations of the veins and arteries, Drainages of the pelvic cavity, and Imaging of various organs. It also released the FY 2021 ICD-10-PCS Official Guidelines for Coding and Reporting.

From a compliance exposure perspective, we believe that the HIPAA risk associated with sending PHI abroad is simply untenable. HIPAA is an American law that does not extend beyond our borders. The only way to ensure HIPAA protection abroad is to do so contractually via a BAA.  There is no regulatory authority abroad for the...

A lot of information is appearing very fast about COVID-19 (coronavirus disease 2019), and medical coders have the extra challenge of sorting through the onslaught to find the bits relevant to coding claims related to testing and treatment. This Q&A brings together the latest authoritative news about coding for COVID-19.

Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to amend the methodology and other requirements for the U.S. Department of Health and Human Services’ risk adjustment data validation (HHS-RADV) program. HHS-RADV was created to strengthen the...