The Centers for Medicare & Medicaid Services (CMS) published the ICD-10-PCS codes and guidelines for the 2023 fiscal year on May 26, 2022. These inpatient procedure codes and guidelines will become effective Oct. 1, 2022.

Are you using something other than two-midnight? Here’s why you shouldn’t be. Is there the possibility that your utilization management team and physician advisors are applying InterQual, MCG, or any other utilization tool other than the two-midnight rule to your Medicare admissions? Over the last few months, it has become clear to me that many hospitals are systemically under coding, classifying patients who...

Just when you think your practice is running without a hitch, it happens. You receive notice of an audit from one or more of your payors, demanding detailed records on one or more of your patients—their beneficiaries. No one welcomes the distraction from clinical care and additional work that an audit requires. That having been said, you need to take these audits seriously, according to AMA Senior Adviser Kathleen Blake, MD, MPH.

How to stay compliant in behavioral health screenings. Behavioral health screenings aim to detect mental health symptoms in many seemingly healthy people. This can be done in various ways, including using paper-based instruments in the exam room, computer-based screening in the waiting area, and physician interviews during routine exams. The goal is to apply these screening methods uniformly to patients with potentially undiagnosed mental health problems. Screening and assessment...