Diagnosis-related group coding determines eligibility for many Medicare bundled payment initiatives. This approach excluded many patients with chronic obstructive pulmonary disease likely to benefit ...

Don't code hospital records prematurely, warns Donna Wilson RHIA, CCS, CCDS, senior director at Compliance Concepts, Inc. Wilson's advice follows a recent article from The Centers for Medicare & ...

ICD-10-CM coding can be challenging for coders in the outpatient setting. It is important to remember that the Official ICD-10-CM Guidelines for Coding and Reporting provide a road map to ensure ...

Diagnosis-based payment systems can create incentives to upcode patients to a higher level of severity to increase payment. In some instances, upcoding can be a form of fraud if providers code ...