Factor children into the risk adjustment equation through awareness. The definition of a pediatric chronic condition is a health problem that lasts over three months, affects the child’s normal activities, and requires many hospitalizations and/or extensive medical care. Approximately 15-18 percent of children in the United States live with a chronic health condition. A pediatric ...
In Billing
Jul 26th, 2019
Diabetes affects more than 30 million people in the United States. In fact, 25 percent of Americans age 65 and older suffer from diabetes, and its prevalence continues to grow as 1.5 million Americans are diagnosed with this deadly disease every year, according to the American Diabetes Association. Your organization can be a part of ...
In Coding
Jun 10th, 2019
With so many complications that involve many specialties, correct coding is essential on many levels. Diabetes mellitus (DM) is a systemic condition prevalent throughout the United States and the seventh leading cause of death nationwide, according to the Centers for Disease Control and Prevention (CDC). There are three main types of diabetes coders will encounter: ...
In Coding
Jun 10th, 2019
Providers no longer need to link documentation to diabetes mellitus for certain related conditions for coding; it’s implied. Medicare risk adjustment (MRA) coders identify active diagnoses that determine a patient’s level of risk (the likelihood of that patient needing medical care). This helps health plans project the cost of caring for their patient population. That ...
In Billing
Jun 21st, 2018
The Centers for Medicare & Medicaid Services (CMS) is modifying its Medicare coverage policy for continuous glucose monitors (CGMs) to support their use in conjunction with smartphones, including the data sharing function CGMs provide. Medicare coverage of therapeutic CGMs began in January 2017, but the policy limited their use in conjunction with smartphones. CMS is removing this limitation in...