Emerging Legal Defenses Against AI-Assisted Medicare Audits: Part I

Published: Thu, 04/25/24

Link to all things medical coding & billing

Emerging Legal Defenses Against AI-Assisted Medicare Audits: Part I

As we know, artificial intelligence is in the spotlight these days. It is being adopted in almost every sector of the economy. It is a commercial product, and the salespeople all argue that AI promises to yield almost incredible improvements in efficiency and accuracy in fields as diverse as supply chain management, screening candidates for HR departments, driving...

The IPPS Proposed Rule Demonstrates the Importance of SDoH

The Centers for Medicare & Medicaid Services (CMS) has issued its 2025 Inpatient Prospective Payment System (IPPS) Proposed Rule, through which it proposes to change the severity designation for several Social Determinants of Health (SDoH) ICD-10-CM codes. The SDoH generally continues to prove to be very important data element across...

Evolution of the International Classification of Diseases

The US is approaching a crossroads regarding the diagnostic coding system that is used in all patient records and information exchanges that support patient care, research, quality measurement, and payment. In 2022, the International Classification of Diseases, 11th Revision (ICD-11)¹ came into effect. In addition, the World Health Organization has...

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).

P.O. Box 3824
Youngstown OH 44513
USA

Unsubscribe | Change Subscriber Options