UnitedHealthcare Cyberattack Underscores need for Increased Government Oversight, Medicare Advantage Reform


By Brian Murphy I’ve been thinking about the disastrous cyberattack, which is costing providers a reported $100M per day. And what it means for the future of healthcare, including Medicare Advantage (MA). UnitedHealthcare deserves no blame for the attack itself. We can blame its lack of preparedness. We should criticize its inadequate response. But they…

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Breaking Down ICD-10-CM 7th Characters for Traumatic Fracture Care

traumatic fracture care

Crystal May, CCS, CPC, CDEO, CPMA, CRC, AAPC Approved Instructor Sr. Risk Adjustment Consultant, Norwood Coders often get overwhelmed with coding traumatic fractures, typically due to the numerous 7th characters available. But coding them isn’t as scary as it seems once you understand how they break down. The first question you must ask is, is…

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AAIM vs. GLIM: Evaluating the Best Tool for Diagnosis of Severe and Other Forms of Malnutrition


By Brian Murphy AAIM or GLIM… which is the better tool for diagnosing severe and other forms of malnutrition? A question not without its share of controversy. For U.S. hospitals and healthcare organizations, the answer is AAIM, according to my recent guest on Off the Record, ECU Health Adult Clinical Dietitian Supervisor Ashley Strickland. These…

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Most Common CDI and Coding Queries: What Are Yours?

cdi and coding

By Brian Murphy What are your most common CDI or coding queries these days? There are always a few at or near the top (you probably know the culprits), but I was interested to see if there were any shifts based on the continued growth of Medicare Advantage/HCCs, social determinants of health, changes in provider…

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Bombshell ACO Whistleblower Lawsuit Highlights Needs for Accuracy, Not Maximization, of Medical Coding

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…

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CDI 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…

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