Proposed 2025 IPPS Rule: CMS Targets Readmission Metrics

Published: Tue, 04/16/24

Link to all things medical coding & billing

Proposed 2025 IPPS Rule: CMS Targets Readmission Metrics

When it comes to healthcare policy, even seemingly minor adjustments can have significant ripple effects across the industry. The Centers for Medicare & Medicaid Services (CMS) recently unveiled its proposed changes for the IPPS for the 2025 fiscal year. Among the notable alterations is a heightened...

CMS releases tool to help hospitals with price transparency

CMS recently released a web-based validation tool that assists hospitals with price transparency compliance. The updated V2.0 Online Validator Tool helps hospitals develop machine-readable files to comply with a federal price transparency regulation that went into effect in 2021. The regulation requires, among other obligations, hospitals to publicly post...

CMS Releases Proposed Rule for IRFs

On March 27, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Inpatient Rehabilitation Facilities (IRFs) that would update payment policies for the 2025 fiscal year (FY) and add four new items as Standardized Patient Assessment Data elements, modify an additional item, and remove the Admission Class item from the IRF-PAI (Patient Assessment Instrument).

4 ways generative AI is transforming healthcare

In the face of ever-rising healthcare costs, technology could offer a reprieve. Indeed, physicians across the country are interested in learning about the potential benefits of AI for themselves and their patients. A recent survey by the American Medical Association (AMA) found that 65% of physicians believe AI offers advantages, particularly when it comes to tools that...

How to Report New Code Category W44

One of the goals of medical coding is documenting encounter notes to the highest degree of specificity. ICD-10-CM had some existing codes for documenting foreign bodies entering through a natural orifice.

Code range T15 through T19 helped document such conditions, but these codes simply referred to a non-specific foreign body. However, the recent update...

How AI is Becoming a Staple in Medical Coding, Auditing

Troves of data flow through the healthcare revenue cycle. Yet, many providers struggle to make sense of the codes and clinical documentation to not only submit clean claims but also understand patient encounters that occur within their organizations.

Medical coding and clinical documentation are ripe...

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