News
Bombshell ACO Whistleblower Lawsuit Highlights Needs for Accuracy, Not Maximization, of Medical Coding
Note: The following is an editorial and should not be substituted for legal advice or counsel. By Brian Murphy If you’re using a vendor promising “big ROI” from their revolutionary coding software—one that requires harried physicians to pick medical codes from dropdown lists—you are setting yourself up for huge fines and public humiliation. We’ve seen…
Read MoreCDI and Coding Professionals: Indispensable Links in the Chain of Care
By Brian Murphy CDI professionals (and clinically astute coders) can positively impact patient care. How? By being mindful during their chart reviews, noticing documentation discrepancies, and bringing them to the attention of the care team. On the latest episode of Off the Record, Lynne Spryszak, RN, CCDS, gave a couple wonderful examples. Lynne was re-reviewing…
Read MoreCDI, Coding Professionals should Stay Abreast of Proposed HEDIS Measures Changes
Comments to NCQA due March 13 By Brian Murphy The National Committee for Quality Assurance (NCQA) wants your comments on proposed changes to the Healthcare Effectiveness Data and Information Set (HEDIS) measures. That’s a lot of acronyms that you may not think pertain to your job. But HEDIS measures matter. A lot. HEDIS is used…
Read MoreWith a Two-Year Revenue Growth of 418%, Norwood Ranks No. 28 on Inc. Magazine’s List of the Southwest Region’s Fastest-Growing Private Companies
Companies on the 2024 Inc. 5000 Regionals: Southwest list had an average growth rate of 135.43 percent. Inc. magazine today revealed that Norwood ranks no. 28 on its fourth annual Inc. 5000 Regionals: Southwest list, the most prestigious ranking of the fastest-growing Southwest private companies, based in Arizona, New Mexico, Oklahoma, and Texas. Born of…
Read MoreCMS Changes Longstanding Policy, Allows Providers to Text Patient Information and Orders
By Brian Murphy Ladies and gentlemen, start your texts. Texting patient information and the texting of patient orders among members of the health care team is now permissible, if accomplished through a HIPAA compliant secure texting platform (STP) and in compliance with the Conditions of Participation (CoPs), according to a recent CMS memorandum. See link…
Read MoreArtificial Intelligence: Beneficial to CDI and Coding Professionals, but also puts Clinical and Coding Knowledge at Risk of Erosion
By Brian Murphy MedPage Today asks: Could AI put clinical knowledge at risk? I’d like to slightly alter the question: Could AI put clinical/coding knowledge at risk, for mid-revenue cycle professionals? I’m intrigued by all things AI. Not just for the obvious reasons (how it works, intellectual property/fair use implications), but also for what AI…
Read MoreNorwood subject Matter Expert Quoted in Fierce Healthcare
Jason Jobes weighs in on impact of $2B Medicare catheter fraud scheme You may have read the national news in the New York Times or elsewhere about an unfolding $2 billion Medicare catheter fraud scheme. The short story is quarterly urinary catheter spend in the US increased nearly 20x last year, likely driven by fraud,…
Read MoreEarly sepsis detection software has a role in CDI/coding efforts, but not a substitute for trained professionals
By Brian Murphy An interesting piece up on the blog of Epic: Reducing mortality and saving money by identifying signs of sepsis sooner. (Note: This is not a commercial for the EHR giant, for which I hold no financial interest). Per the article, after implementing v. 2 of Epic’s Early Detection of Sepsis cognitive computing…
Read MoreHealthgrades Best Hospitals rankings announced: How much emphasis does your CDI or coding departments place on these or other awards?
Survey says: 57% place focus on these methodologies, 40% do not By Brian Murphy Healthgrades recently announced its top 50, top 100, and top 250 hospitals awards. I’ve listed the 50 hospitals below; do you see your home state or hospital represented? Per its website, Healthgrades America’s 50 Best Hospitals Award™ recognizes 50 hospitals as…
Read MoreOM(G2211)! New HCPCS code leaves mid-revenue cycle professionals with lingering uncertainty
By Crystal May, CCS, CPC, CDEO, CPMA, CRC, AAPC Approved Instructor Senior Risk Adjustment Consultant, Norwood From the beginning, new HCPCS code G2211 has been surrounded by questions, uncertainty, and controversy. G2211 was supposed to be implemented in 2021, with CMS originally stating it would be “a single add-on code describing the work associated…
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