In Coding
Apr 1st, 2019
Documentation is key to correct ICD-10-CM coding, better patient care, and proper reimbursement. Physician documentation is one of the most important keys when abstracting for hierarchical condition category (HCC) coding. In a value-based payment system, documentation — more specifically, coding extracted from that documentation — determines whether a physician is properly compensated for managing ...
The Centers for Medicare and Medicaid Services (CMS) released a Final Rule freeing more than $10.4 billion to anxious payers to continue the Affordable Care Act’s (ACA) risk adjustment program. The agency had halted payments to payers while a New Mexico ruling was challenged, but in the end the activity unnerved the industry and didn’t change much. Risk Adjustment ...
Jun 12th, 2018
The typical path to becoming a medical coder starts with a recently graduated high school student who is detail-oriented, enjoys healthcare and anatomy, and learning about medical records and the physician revenue cycle. But not all medical coders start out that way. Some people pursue a career in medical coding because there is the potential to work ...
In CMS
Mar 5th, 2018
Risk adjustment helps to ensure accurate and adequate payment for Medicare Advantage (MA) patient conditions, based on expected medical costs. A patient’s health status reflects the costs associated with their healthcare needs. The more of a burden the disease is, the higher the risk adjustment score is. Healthier patients have a lower risk adjustment score. Hierarchical ...
Medical groups and health systems that are members of the American Medical Group Association (AMGA) estimate that 60 percent of their Medicare revenues will be risk-based in 2019, pointing to a greater need for risk-assessment coders. Fierce Healthcare reports respondents to the organization’s annual risk survey said they expect revenues from Medicare Advantage to equal ...