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Test Your Knowledge: December 2022

Test Your Knowledge: December 2022

73-year-old male with a past medical history of ventral hernia with 3 prior surgeries presented to ED complaining of worsening abdominal pain with nausea.Day of presentation: 2053: CT demonstrated SBO with thick-walled small bowel loop in ventral hernia. 2218:...

Bulletin 16 – CMS 2023 IPPS & LTCH Final Rule

Bulletin 16 – CMS 2023 IPPS & LTCH Final Rule

On August 1, 2022, CMS released the FY 2023 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Hospitals (LTCH PPS) Final Rule (CMS–1771–F), which was finalized and became effective on November 1, 2022.

On-Demand: HCC’s What’s the 411 for the Inpatient: CDS & Coder

On-Demand: HCC’s What’s the 411 for the Inpatient: CDS & Coder

Join us for an overview of CMS HCC risk adjustment fundamentals for the inpatient clinical documentation specialist and coder. We will review the top ten commonly under-reported diagnoses that map to a CMS HCC, review how risk scores are calculated, impact payment, and benefit from improved clinical documentation and comprehensive coding.

Test Your Knowledge – November 2022

Test Your Knowledge – November 2022

70-year-old male with a past medical history significant for nephrolithiasis, MI, CABG, CVA and DM presented to ED with 1 day history of worsening right flank pain, nausea, vomiting and chills. Seen one day earlier with CT demonstrating a stone in the right mid-ureter...

How to Get Off the Denial and Appeal Merry-Go-Round

How to Get Off the Denial and Appeal Merry-Go-Round

It’s a familiar pattern with payers, the provider wins a front-line denial, then a myriad of payer reviews occur and result in more denials. More provider resources are deployed to fight each subsequent denial, only to be unfairly under-reimbursed at the end of the cycle.

Test Your Knowledge – October 2022

Test Your Knowledge – October 2022

71-year-old female with a past medical history significant for HTN, pulmonary sarcoidosis, multiple back surgeries and loss of bladder function requiring self-catheterization presented to ED complaining of palpitations and associated urinary frequency.

On-Demand: Nuances Around the 2-Midnight Rule

On-Demand: Nuances Around the 2-Midnight Rule

Part 1Part 2Have you ever wondered what you need to document to support an unexpected recovery?  Or when is a Condition Code 44 the best choice?  Can you write and inpatient order after a discharge order? PRESENTED BY Dr. Jerilyn Morrissey Senior Vice President,...

Test Your Knowledge – August 2022

Test Your Knowledge – August 2022

78-year-old female with a past medical history significant for chronic kidney disease, hypertension and diabetes returned to the ED with rectal bleeding that had worsened since her visit the day prior. Initial Hgb 10.9   Day of presentation: 0845: Observation...