News
OIG report on mechanical ventilation raises compliance red flags
By Brian Murphy Medicare improperly paid hospitals an estimated $79 million for patients who received mechanical ventilation. Is your healthcare organization among them? The OIG released a new report taking aim at MS-DRGs 207 and 870. It selected for review a random, stratified sample of 250 claims submitted between 2015-2021 with payments…
Read MoreMake ethics the top of your operating set of principles
By Brian Murphy ACDIS recently updated its Code of Ethics. It’s worth reading; I’ve linked to it below. Even if you’re an industry old-timer I recommend a refresher, to remind yourself what should be at the top of your operating set of principles. We can debate the finer points of ethics as…
Read MoreNorwood ranks No. 682 on 2024 Inc. 5000 list
For the 2nd straight year, Norwood makes the cut with three-year revenue growth of 694% NEW YORK, August 13, 2024 – Inc. revealed today that Norwood ranks No. 682 on the 2024 Inc. 5000, its annual list of the fastest-growing private companies in America. This prestigious ranking provides a data-driven look at the most…
Read More2025 IPPS final rule has something for everyone in CDI, inpatient coding
New CCs and MCCs, TEAM model implemented, and new quality measures among other changes By Brian Murphy The 2025 Inpatient Prospective Payment System (IPPS) final rule is out, and takes effect Oct. 1, 2024. These rules are always long and this one is no exception, but here’s some interesting bits I pulled out for CDI…
Read MoreMeet MEAT criteria to shore up your risk adjustment coding against denial
By Joanne Wilson, RN, ASN, CCDS, Senior Director, Solutions Monitoring, evaluating, assessing, or treating—also known as MEAT—is a well-known and helpful concept organizations and coding professionals should use in the risk adjustment space. Adequate MEAT criteria can shore up claims from denial and prevent costly takebacks from auditing agencies—and remove the bullseye from your organization’s…
Read MoreHealthcare Organizations (and providers) Liable for Inaccurate Coding, not Technology Vendors. Not fair, but a reality.
By Brian Murphy Who will watch the vendor? Will vendors be held accountable for not just accurate coding, but inaccurate coding and errors and repayment, when machines they manufacture are doing more and more of the work? Tesla has delivered self-driving cars, but these incredibly sophisticated machines are not without fault. In 2019 two pedestrians…
Read MoreNew ICD-10-CM Codes and Guidelines are out, take effect Oct. 1
By Brian Murphy The new ICD-10-CM codes and Official Guidelines are out. I’ve included relevant links below. There are 252 new codes, 36 deleted, and 13 revised codes. These take effect October 1, 2024. Here are some interesting additions, from my non-clinical perspective: Obesity classes added to E66.8 Other obesity. These include the following: E66.811 Obesity,…
Read MoreAudit Provider Documentation to Ensure Accurate Risk Adjustment
Norwood performs CMS compliance-level audits for its partner organizations. These audits involve: Evaluation of provider documentation Review of billed codes Determining whether codes are supported in the documentation Evaluating code accuracy Determining whether a higher (or lower) degree of specificity is warranted Following these steps, we compile the results into a detailed summary of the…
Read MoreOutpatient CDI Specialists (especially with CCDS-O certification) Are in Demand
By Brian Murphy Where are all the CCDS-Os? That’s Certified Clinical Documentation Specialist—Outpatient. Outpatient CDI and risk adjustment are exploding. I know this because our clients are building and expanding their programs, and on the hunt for individuals possessing this rare credential. Of which there’s only a few hundred operating in the wild. You want…
Read MoreStart Your Journey with the Norwood Outpatient CDI Boot Camp
Our campers are all smiles. To learn more or schedule a call contact us at info@norwood.com. Download the brochure here. Risk adjustment is a team sport. Accurately depicting the complexity of a broad patient population across your organization requires contributions from patient registration to providers—and everyone in between, including well-trained risk adjustment coding and…
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