Get the most up-to-minute news and information on ICD-10. Join Chuck Buck and Erica Remer, MD, FACEP, CCDS, every Tuesday as they welcome ICD10monitor contributing editors and special guests to monitor and report on the progress that all healthcare stakeholders are experiencing in their respective implementations of ICD-10. Register to attend live here: https://event.webcasts.com/starthere.jsp?ei=1236510&tp_key=da0e4c0f76
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Analyzing America’s Collective Mental Health, Post-Election
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In the wake of last Tuesday’s Presidential Election, the producers of ICD10monitor and Talk Ten Tuesdays have invited world-renowned psychiatrist H. Steven Moffic, MD to analyze America’s collective psyche. As in all election outcomes, there were losers and winners. Yet how we, as Americans, manifest these feelings will be the essence of the next l…
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The IV Drought: A Survival Guide for Healthcare Heroes
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Feeling parched? Well, you’re not alone. Hospitals across the country are dealing with a saline shortage. Thanks to Hurricane Helene’s unwelcome visit to the Baxter International facility in North Carolina, your IV bags may be running low. Imagine a busy highway suddenly reduced to a single lane: that’s what this IV shortage feels like for impacted…
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Don’t Code for Panic: Understanding the New Medicare Appeal Process
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The panic was widespread. Rumors were flying. Cellphone alarms were sounding. From large hospital conference rooms to upholstered cubicles, everyone seemed to have the same sense of disbelief and mounting frustration: Acentra Health (previously Kepro) had announced a new appeal process for Medicare patients – specifically, those whose status change…
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Rules of Engagement: Learning to Code Better, Faster, and More Accurately
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The Rules of Engagement for medical coding and clinical documentation integrity (CDI) are based on four authoritative sources: the ICD-10-CM/PCS Official Coding Guidelines, the American Hospital Association (AHA) Coding Clinic Advice, the American Health Information Management Association (AHIMA) Standards of Ethical Coding, and practice briefs. Th…
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The American Hospital Association’s (AHA’s) Coding Clinic edition for the fourth quarter of 2024 has been published, and it includes several key changes of which providers nationwide should take heed. And that is why the producers of ICD10monitor have invited renowned subject matter expert Dr. James S. Kennedy to delve into the details and provide …
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Health and longevity are within reach for everyone, no matter from where you’re starting. And it’s never too late to begin. During the next live edition of Talk Ten Tuesdays, Dr. Nick van Terheyden will cover some key areas upon which to focus so you can start bringing about improvements in your life by making small, consistent changes that are exp…
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Eleven Key Takeaways from the 2025 ICD-10 Code Updates
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The Centers for Medicare & Medicaid Services (CMS) has released the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code updates for the 2025 fiscal year (FY). The FY 2025 ICD-10-CM updates introduce more than 300 code changes, including 252 new codes, 13 deletions, and 36 revisions, reflecting ongoing ad…
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Sleep Deprivation: Study Reveals Serious Health Implications
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Sleep is essential for all living organisms, from jellyfish to humans, and even bacteria have phases that resemble rest. Experiments show that severe sleep deprivation is lethal, as seen in rats, fruit flies, and Randy Gardner's 1964 11-day sleepless experiment. But what does it mean for you? Join Dr Nick as he explores a natural experiment in slee…
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Dissecting the Holy Grail of Medical Record Coding
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Elusive and seemingly unattainable, the crux of medical record coding essentially can be distilled into these apparently irreconcilable elements—accuracy, speed and knowledge. Overlay on this current situation the incessant need to be aware of constant updates, inevitable staffing changes, the apparent searching for some 74,000 codes and the ensuin…
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Ships and airplanes apparently vanish into thin air. Mystery abounds. It’s the legendary Bermuda Triangle. But wait! Might there also be a healthcare Bermuda Triangle? Internationally renowned psychiatrist Dr. H. Steven Moffic will make the case for just that during the next live edition of Talk Ten Tuesdays. Dr. Moffic will report on the three key…
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Making the Case for Artificial Intelligence to Reduce Coding and CDI Costs
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As senior healthcare leaders and stakeholders continue to look for ways to reduce coding and clinical documentation integrity (CDI) resource expenditures, making the business case for new technology such as artificial intelligence (AI) has never been more essential than it is right now. That is why the ICD10monitor producers of the popular Talk Ten…
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The Patient Safety Structural Measure: A New Initiative Designed to Reduce Medical Errors
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Recognizing that preventable medical errors, infections, and injuries are estimated to account for the deaths of 250,000 people annually, the Centers for Medicare & Medicaid Services (CMS) has expanded public reporting by hospitals on rates of patient safety events. Furthermore, CMS recently introduced the Patient Safety Structural Measure, effecti…
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2025 OPPS Proposed Rule: Important Changes Coming to the Hospital Outpatient Quality Reporting Program
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The Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) Proposed Rule includes proposed policies that align with several key goals for the agency, one of which is promoting safe, effective, patient-centered care. CMS has several quality measure changes being proposed to the Hospital Outpatient Quality Reporti…
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News reports, essays, and technical papers continue to laud the efficacy of generative article intelligence (AI) in healthcare. But what about AI and its application to the revenue cycle? Cassi Birnbaum, formerly the administrative director at Stanford Medicine Health Care, is set to return to Talk Ten Tuesday with an exclusive report on how AI can…
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National Coding Roundup: Preparing for the New FY2025 IPPS Final Rule
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The summer is here, and it’s raining codes. There are ICD-10 codes, CPT® codes, and the Z codes. Plus, coming up is the 2025 Inpatient Prospective Payment System (IPPS) Final Rule, which is expected to contain some new codes and deletions of others, for an expected net total increase of ICD-10 codes. In preparation, the producers at ICD10monitor ha…
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Scorching Reality: The Health Impacts of Excess Heat and Climate Change
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As global temperatures soar and heatwaves become more frequent, the connection between climate change and rising heat is undeniable. The results are not limited to uncontrolled wildfires but extend to widespread health consequences of excess heat from immediate threats like heat exhaustion and heat stroke to the exacerbation of chronic conditions s…
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2025 OPPS Proposed Rule: Significant Changes Impacting Medicare Payments Revealed
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The Centers for Medicare & Medicaid Services (CMS) has released the Outpatient Prospective Payment System (OPPS) Proposed Rule for the 2025 calendar year (CY). This published information outlines significant changes impacting Medicare payment policies for hospital outpatient services. Key proposals include adjustments to payment rates, updates to t…
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What is “Chevron deference?” And why is it important – especially to health information management (HIM) professionals? And who among the most learned and wise HIM professionals is arguably best qualified to report on this otherwise arcane judicial principle? That would be the legendary Rose T. Dunn. Dunn has offered to speak on this topic during t…
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Hello, CMS: Are You Listening? Add-on Code G2211
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Where in the world is G2211? Both payers and providers still report lack of information from the Centers for Medicare & Medicaid Services (CMS) about use of this code. If you remember, CMS promised stakeholders an FAQ document back in January. To date it has not been released. And yet, knowing how to document the service is probably the most-asked …
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Why MedPac Chapter 12 is Fast Gaining Attention
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Each year the Medicare Payment Advisory Commission, MedPAC, provides Congress a report on the Medicare fee-for-service (FFS) payment systems, the Medicare Advantage (MA) program, and the Medicare prescription drug program (Medicare Part D). Within the MedPAC report is also the often (until now) under-reported Chapter 12. During the next live editio…
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Mental Health Coping Strategies for Brutal Summer Heat
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With summertime fast approaching, also on the horizon are the inevitable stressors leading to increased psychiatric diagnoses and possible surges in psychopathologies. As temperatures increase, so do incidents of mental health unrest – tempers flaring, mood disorders, and possible cognitive impairment. That is why, with summer officially entering o…
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He once explained to us the value of sleep, and gave tips on how to get more of the once-devalued therapy. That was then. This is now. And during the next live edition of Talk Ten Tuesdays, Dr. Nick van Terheyden will turn his attention to another vital healthcare issue: nutrition. This buzzworthy topic is becoming increasingly relevant as the Whit…
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Welcome to the 600th live edition of the long-running Talk Ten Tuesdays broadcast, produced by ICD10monitor. In commemorating this special edition, the producers are pleased to welcome the legendary Rose T. Dunn, chief operating officer at First Class Solutions, Inc. in St. Louis, a healthcare information management leader since 1988. Rose is the a…
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Mental Health Report: Coping with Psychopathologies
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In recognition of May’s National Mental Health Awareness Month, ICD10monitor and Talk Ten Tuesdays have invited world-renowned psychiatrist and award-winning author H. Steven Moffic, MD to update his theory of social psychopathologies for the next live edition of the weekly Internet radio broadcast. According to Dr. Moffic, those are harmful indivi…
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Modifier 25: Where, When, and How to Use It Correctly
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As if buried in shifting sands like a booby trap, Modifier 25 is poised to wreak havoc on claims when it’s appended incorrectly to an evaluation and management (E&M) charge – typically to indicate a separate service on the same date of service. So, what’s a provider to do? When is it actually appropriate to append Modifier 25? How do providers indi…
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The ongoing consolidation of independent physician practices, in many cases resulting in ownership by private equity groups and large health systems, is causing a shift from traditional medicine to the corporate practice of medicine. The result often is not in the best interest of patients, given that the focus tends to be on maximizing profits rat…
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Out with the Old, In with the New: Patient Access Systems
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There’s a renewed sense of urgency. Today’s healthcare providers must modernize their approach to patient access and financial clearance operations, according to Matt Bridge, senior vice president of AGS Health and the special guest during the next live edition of Talk Ten Tuesdays. Bridge is expected to report on the pitfalls of using outdated pat…
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Sleep: Underrated, Undervalued, and Now a U.S. Health Crisis
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Tired of tossing and turning? You’re not alone. A Gallup poll released last Monday revealed that 57 percent of Americans said they would feel better if they could get more sleep. And that is why ICD10monitor and Talk Ten Tuesdays invited Dr. Nick van Terheyden – to investigate our national sleep crisis. During the next live edition of the long-runn…
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Transforming Patient Access Services: A Blueprint for Healthcare Success
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Properly managed patient identity queues are the foundation of an effective master person index that minimizes issues and facilitates streamlined care coordination. Conversely, unresolved identity queue backlogs can have costly implications for patient care, safety, and revenue integrity. It’s a growing problem with a time-consuming, resource-inten…
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Saluting World Health Day in Preparation for ICD-11
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World Health Day will be observed on Sunday, April 7 but on Tuesday, April 9, 10 a.m. Eastern Time, Talk Ten Tuesday will recognize World Health Day with the special guest appearance of Lorraine Fernandes, immediate past president (2019-2022) of the International Federation of Health Information Management Association (IFHIMA). Today, Fernandes ser…
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Data Breaches: What Every Coder Needs to Know
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The continued onslaught of cybersecurity attacks is only getting worse. These attacks have impacted the healthcare system in dramatic fashion, starting with the Change Healthcare payment network being brought down. Hopefully, everyone – including coders – will be more vigilant and wary of potential attacks and attempts to breach security. The const…
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New Code W44: The Ins and Outs of New Foreign Bodies
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In a move towards greater specificity, the nation’s healthcare providers have a new ICD-10-CM code category: Code W44. Having gone into effect October 2023, the new code category (foreign body entering into or through a natural orifice) is seen as enhancing specificity, although Code W45 had already existed for foreign bodies entering through the s…
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Looking Ahead to What the Future Holds with ICD-11
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On the horizon, looming like an ominous thunderhead, is ICD-11. But wait! There’s more: the expanding role of coding in big data, for example. The evolving healthcare IT, and how it will redefine the coding profession. All this and more is coming your way. That’s why ICD10monitor and Talk Ten Tuesdays invited senior healthcare consultant Angela Com…
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Code G2211 continues to be a gift disguised as something else. As many nuances surrounding the code continue to linger, there are still some areas that are not as clear-cut as many healthcare professionals would prefer. As a refresher, G2211 allows providers (primary care, as well as specialists) to bill for additional cognitive work effort that is…
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Hospital Star Ratings: How to Earn Back Fallen Stars
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How many hospital star ratings does your facility have? Do you know? If you don’t, you’re not alone. Apparently, many coders and clinical documentation integrity specialists (CDISs) don’t know. But you should know. That’s why ICD10monitor and Talk Ten Tuesdays have invited Michelle Wieczorek, a registered nurse (RN) and a CDI authority, to explain …
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Good News: The Flip Side of Social Psychopathologies
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During the next live edition of Talk Ten Tuesdays, award-winning author H. Steven Moffic, MD, considered to rank among the world’s most renowned psychiatrists, will report on what he calls “social psychoexemplaries” – the other side of what he reported two weeks ago on social psychopathologies. Moffic, in his popular daily column in Psychiatric Tim…
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Safe Handling Instructions for Code G2211
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What are the “do’s” and “don’ts” for the safe handling of HCPCS code G2211, used to report payment to physicians and other qualified healthcare providers for the additional work required to adequately care for patients with serious or complex conditions? The code is now payable for the 2024 calendar year (CY). Not only has the code quickly become e…
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Leveraging Revenue Cycle Management: New Series Begins Today
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Achieving high-performing revenue cycle management (RCM) begins with understanding where your healthcare organization falls on the RCM Maturity Framework, according to Matt Bridge, senior vice president for AGS Health. Bridge, who will be the special guest during the next upcoming edition of Talk Ten Tuesdays, says this four-stage framework informs…
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Searching for a New Z Code: Psychopathologies
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We are all familiar with DSM-5 and ICD-10 for the classification of various mental disorders. Both, but especially ICD, also cover some of the social conditions needing medical attention that may or may not be connected to the primary disorder or illness. ICD does that in the Z codes. However, Z codes are used infrequently. Moreover, many social pr…
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There’s a New Code in Town: Condition Code 92
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New Condition Code 92 is here, and it’s effective now. The code outlines the billing requirement for intensive outpatient program services for hospital outpatient departments, critical access hospitals (CAHs), and community mental health centers (CMHCs). To explain what you need to know about correctly billing the new Condition Code 92 during the n…
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Shrouded in controversy, the HCPCS code G2211 was released in 2021, proposed by the Centers for Medicare & Medicaid Services (CMS) to pay physicians and other qualified healthcare providers for the additional work required to adequately care for patients with serious or complex conditions. The code is now payable for calendar year (CY) 2024. The jo…
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Never Before Reported: The Impact of 2021 E&M Changes on 2024 E&M Coding
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Last year, healthcare professionals saw many of the rules for evaluation and management (E&M) services that were implemented in 2021 now applied to 2023 E&M codes. This included codes representing services for hospital inpatient care (99221-99223 and 99231-99233), emergency department visits (99281-99285), nursing facility visits (99307-99210), and…
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AMA and CMS Alignment on Split/Shared E&M Visits
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Codes for split (or shared) evaluation and management (E&M) services for 2024 have been revised, simplified, and aligned by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS). During the next live edition of the long-running Talk Ten Tuesdays broadcast, 3M Senior Consultant Colleen Deighan-Ejak will repo…
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Warning: New Add-on Payment Code for E&M Coming
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There’s a new code in town. It’s an add-on code, HCPCS Code G2211. And its effective date is Jan. 1, 2024. The new code is associated with the continuing focal point for all needed medical services that are part of ongoing care related to a patient’s single, serious condition, or complex condition. The Centers for Medicare & Medicaid Services (CMS)…
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Warning: New Changes to MDS Assessments for SNFs
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There are substantial new changes to the minimum data set (MDS) assessment, including how functional abilities and goals are scored, the introduction of tracking of indications for medication use, and the addition of new measures for tracking communication of transfer-of-health information. The recent changes became effective Oct. 1, the start of t…
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MINOCA and INOCA: Twin Aspects of a Cardio Conundrum
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MINOCA (myocardial infarction with non-obstructive coronary arteries) and INOCA (ischemia with non-obstructive coronary arteries) pertain generally to coronary artery disease. During the next live edition of the long-running and popular Internet broadcast Talk Ten Tuesdays, Pam Scott will take you on a coding journey into these conditions and the m…
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With thousands of followers on social media, Dr. Robert Oubre, aka “The Doctor of Documentation,” will make his Talk Ten Tuesdays debut on Tuesday, Nov. 7, when he will be the broadcast’s special guest. Dr. Oubre will be reporting on what documentation considerations should be given when patients are reading physician notes appearing on the monitor…
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Like autumn leaves, new codes and guidelines are raining down on hospitals and physician practices, impacting coders, clinical documentation integrity specialists (CDISs), and professionals managing the revenue cycle. And while there appears to be no respite, the weary can take comfort during the next live edition of the long-running and popular Ta…
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Navigating the New Normal: Understanding Telehealth Coding and Documentation
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As the demand for telehealth services has surged, the nuances of coding and documentation for virtual visits present unique challenges and opportunities. During the next live edition of Talk Ten Tuesdays, Angela Comfort will delve into the specifics of coding for telehealth, including the evolving Centers for Medicare & Medicaid Services (CMS) guid…
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An Insider’s View of the AHA Coding Clinic
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A must-have resource for any coding or clinical documentation integrity specialist (CDIS) is the American Hospital Association (AHA) Coding Clinic. Each quarterly issue provides official guidance for ICD-10-CM and ICD-10-PCS coding for all healthcare settings. The third-quarter issue covers a variety of topics, from prescribed marijuana use for chr…
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