Query Compliance...Time to Confirm This!

Gloryanne Bryant, RHIA, CDIP, CCS, CCDS CMS Leave a Comment

Within Clinical Documentation Integrity (CDI) and clinical Coding we have verbal, written and electronic documentation clarifications or querying. A key component of the clinical documentation query is achieving and maintaining compliance. Having a written policy and procedure in place along with a formal quality review process for querying is thus essential and a must. ...

HHS Releases Strategic Plan FY 2022–2026

Heather Chartier, MS, RHIA, CCA HHS Leave a Comment

In March 2022, the U.S. Department of Health and Human Services released the updates for its Strategic Plan. All operating and staff divisions within the HHS and input from Congress, Tribes, Tribal, and Urban Indian Organizations, the Office of Management and Budget, and the public sector contributed to its development. For FY 2022 – 2026, HHS addresses and tracks five...

CPT Updates for 2022: Musculoskeletal System Section

Caitlin Wham, CCS CPT updates Leave a Comment

Each year the AMA (American Medical Association) publishes new, revised, and deleted codes to the CPT code set, including logic and rationale related to the updates. The CPT code set for 2022 includes extensive changes to the Musculoskeletal System section, which had a large number of updates in both guidelines and definitions. The key changes to the Musculoskeletal...

OIG: Annual Medicaid Fraud Control Unit Report

Gloryanne Bryant, RHIA, CDIP, CCS, CCDS OIG Leave a Comment

The Office of Inspector General (OIG) released in mid-March 2022 their annual report and statistics for 53 Medicare Fraud Control Units across the country. Significant investigative work and recoveries were obtained in 2021 totaling $1.7 billion recovered and 1,105 convictions. The 2021 annual Office of Inspector General (OIG) Medicaid Fraud Control Units (MFCUs) report...

What Code Should You Assign for Scleroderma? Well, it Depends…

Becky Buegel, RHIA, CDIP, CHP Medical Coding Leave a Comment

Your next chart has the diagnosis “scleroderma.” Being familiar with medical terminology, you know “sclero” means “hard”. Derma, of course, means skin, so the diagnosis means hard/hardened skin. If you’re using coding books instead of an encoder, you’re probably thinking skin codes fall under Chapter 12 – Diseases of the Skin and Subcutaneous Tissue as you flip through...

CPT Updates for 2022: Key Changes and Highlights

Caitlin Wham, CCS CPT updates Leave a Comment

The CPT code set for 2022 includes 249 new codes, 93 revisions, and 63 deleted codes that went into effect January 1st, 2022. Changes in codes and guidelines were made in all sections of CPT- so be sure to review the 2022 CPT code set in its entirety to ensure proper coding and reporting. Key changes in the Surgery section will be highlighted in this blog. Integumentary...

Reportability of Pituitary Adenomas with Spontaneous Regression

Michele Webb, CTR Oncology Leave a Comment

Pituitary adenomas are tumors of the anterior pituitary gland. Most are slow-growing and benign. They are classified based on size or cell of origin and described as microadenoma, macroadenoma, or giant tumors. Microadenomas are usually less than 10 mm in size, while macroadenomas are larger than 10 mm. Giant pituitary tumors are bigger than 40 mm. Adenomas are further...

4 Charge Capture Process Approaches & Reasons for Inaccuracies

Heather Chartier, MS, RHIA, CCA Auditing Leave a Comment

Proper charge capture processes are essential to compliance regulations. An outdated, non-existent, or poorly thought-out charge capture workflow can be devastating to a hospital and healthcare system’s bottom line. Overcharging can be just as harmful as undercharging for medical services. The key to appropriate charge capture processes has shifted from a solely...

ICD-10-PCS Guideline Updates for FY2022: Key Changes

Caitlin Wham, CCS Medical Coding Leave a Comment

In 2021, CMS released the Official ICD-10-PCS Coding Guidelines for fiscal year 2022, which went into effect October 1st. The FY 2022 PCS guidelines include three guideline revisions in the Medical and Surgical section (B3.7, B4.1c, B4.8) and two guideline revisions from the New Technology section (E1.a, E1.b). Although key changes will be highlighted in this blog, be...

CoC Launches New Quality Measures in 2022

Michele Webb, CTR Oncology Leave a Comment

The Commission on Cancer (CoC) requires accredited programs to treat cancer patients according to nationally accepted measures endorsed by the CoC. The measures are included in the Rapid Cancer Reporting System (RCRS) tool for monitoring and reporting purposes. Standard 7.1 states that each calendar year the expected performance rate should be met for each of the quality...

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