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By Brian Murphy One of the hard truths about medical coding is that codes can only be assigned based on documentation from the patient’s provider. More specifically, a qualified physician or other practitioner who can be held legally accountable for rendering a patient’s diagnosis. This rule undoubtedly is a source of frustration and even provider…

By Brian Murphy CMS in April released the 2026 Medicare Advantage final rule. Here’s three important items you should know about. Between this and the 2026 IPPS proposed rule we’re drowning in rules, so if you hope to stay on top it’s important to read what experts have to say. One such person is Richelle…

The FY 2026 IPPS proposed rule is out… what does it contain? With the change in administration I wondered if we wouldn’t see a delay or even suspension of new IPPS rules. That wasn’t the case. The rule was published Friday, April 11. Overall, no huge changes or surprises. I wouldn’t call the 2026 IPPS…

By Brian Murphy Health is far more than just biology, pathophysiology, or medical facts about a patient. Non-medical factors influence health outcomes, including the conditions into which people are born and live. Think about housing instability, lack of access to care, poor food security, and (un)employment. Today we call these social determinants of health (SDOH).…

Norwood is pleased to announce its new Inpatient CDI Boot Camp has been approved for 18 CEUs by AHIMA* and ACDIS ** (see full details below). This three-day in-person class offers client partners in-depth training on critical CDI concepts that improve the financial and quality health of their organization, including opportunities by Major Diagnostic Category,…

By Brian Murphy Functional quadriplegia (ICD-10-CM code R53.2) was a big deal back in my ACDIS days, for a few reasons: 1). It wasn’t a term physicians typically used/documented, even though it’s a common condition among certain populations. Physicians and other caregivers are more apt to use “bedbound, total care” or other such terms.  2)…

By Brian Murphy Could artificial intelligence (AI) increase physician burdens—and burnout? This headline from Healthcare Dive (see link to full article in the comments) is provocative … but might not be clickbait. This is admittedly a complex issue with a lot of “it depends.” It depends on what product you’re using. It depends on what…

By Brian Murphy An update to the ICD-10-CM Official Guidelines for Coding and Reporting (OCG) is out. These changes take effect April 1. I’ve provided the link below. The following three changes are of particular importance to CDI and coding professionals. I recommend reviewing the entire document which won’t take long; as a reminder, the…

By Jason Jobes, SVP, Solutions Best Practice Tip: On January 1st of every year identify what percentage of your patients’ risk-based contracts have a scheduled PCP appointment. As full implementation of V28 of CMS-HCCs looms larger, I want to share a best practice I discuss with our partners. What percent of your patients have their…

By Brian Murphy What does it mean to work as a clinical documentation integrity (CDI) or inpatient coder in a high-tech, AI-enabled environment? I got a glimpse of the future (for some, the present) this week while attending the ACDIS Virtual Symposium. And jotted down a few pros/cons as I see them, from the perspective…