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OIG Workplan: Review Medicare Inpatient Hospital Billing for Sepsis The OIG will be reviewing Medicare claims to assess patterns in the inpatient hospital billing of sepsis in 2023 and describe how the billing of sepsis varied among hospitals. The definition of and...
Dural Tear Clarification Per Coding Clinic, First Quarter 2024: A dural tear is clinically significant and should always be reported when documented by the provider. G97.41, accidental puncture or laceration of dura during a procedure is a CC...
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Myocardial Infarction with Angina Per Coding Clinic, First Quarter 2024: Is it appropriate to assign a code for CAD with angina for the severe native multi-vessel disease that resulted in the MI? Examples: Assign code I21.4: Non-ST elevation (NSTEMI) myocardial...
UnderdosingPer Coding Clinic, First Quarter 2024: Underdosing when a PRN medication is not taken Example: Documentation states: A patient presents to the ED with shortness of breath due to an exacerbation of asthma. The patient did not take his PRN medication,...
When a Midwest-based provider of behavioral health services faced a critical challenge in its Clinical Documentation Improvement (CDI) operations, they turned to e4health.
When senior leadership at a mid-Atlantic health system faced the critical challenge of ensuring the appropriateness of provider responses to Clinical Documentation Improvement (CDI) queries, they turned to e4health.
New Codes for Sickle Cell Disease with Dactylitis (Valid for October 1, 2023 discharges)• D57.04 Hb-SS disease with dactylitis• D57.214 Sickle-cell/Hb-C disease with dactylitis• D57.414 Sickle-cell thalassemia, unspecified, with dactylitis• D57.434 Sickle-cell...
Complication Comorbidity UpdateSocial Determinants of Health (SDOH) codes Z59.00, Homelessness unspecified, Z59.01, Sheltered homelessness and Z59.02, Unsheltered homelessness will be considered CC’s (complication/comorbidity) beginning with October 1, 2023...
New Code for Resistant Hypertension (Valid for October 1, 2023 discharges)I1A.0 Resistant hypertension May be documented as: Apparent treatment resistant hypertension, Treatment resistant hypertension, True resistant hypertension. The ICD-10-CM Tabular instruction...
When a 125-bed acute care medical center located in the heart of Eastern Long Island, New York, needed assistance taking their Clinical Documentation Integrity (CDI) Department to the next level, they turned to e4health.
Medicare Advantage is on the brink of a significant restructuring as it transitions from V24 to V28 of the hierarchical condition categories (HCCs) risk adjustment model. In a recent Journal of AHIMA article, I partnered with Jeanie Heck, BBA, CCS, Education...