In the complex world of modern healthcare, a patient’s journey is shaped by more than just their medical diagnosis. Factors like housing stability, access to nutritious food, reliable transportation, and social support networks—collectively known as Social Determinants of Health (SDOH)—are increasingly recognized as powerful drivers of health outcomes. While healthcare systems have the tools to […]
For the 2026 ICD-10-CM code updates, you’ll find 16 new “R” codes that offer greater detail for reporting pain and tenderness in the pelvic, perineal, subpubic, abdominal, and flank regions. The existing code R10.2- (Pelvic and perineal pain) will become a parent code. A notable addition is R11.16 (Cannabis hyperemesis syndrome (CHS)), specifically for nausea […]
2025 CMS Proposed Rule: Announcing this week a proposed rule for inpatient and long-term care hospitals (LTCHs) for the fiscal year of 2025 (FY), federal officials cited an increasing focus on social determinants of health (SDoH). The Centers for Medicare & Medicaid Services (CMS) also prioritized improving maternal health and strengthening emergency preparedness, which noted […]
Greetings and welcome to the latest edition of our healthcare coding newsletter! In order for us to remain abreast of the ever-evolving landscape of medical documentation, we must stay up-to-date with updates to the International Classification of Diseases, Tenth Revision (ICD-10) from time to time. In this article, we will take a closer look at […]
AI represents a promising frontier, especially in healthcare, where leveraging vast information could revolutionize problem-solving. However, a shadow looms over AI, as anticipated by many. In the realm of health insurance and patient care denials, AI has already stirred controversy, leading to a notable class action lawsuit. According to reports from healthcare News, Health Insurance […]
The fiscal year 2024 ICD-10-CM codes have recently become active, and they will have an impact on your reimbursement. Earlier this year, CMS announced the incorporation of 395 fresh diagnosis codes, removal of 25 codes from the diagnosis set, and modification of 13 codes— all of which became effective on October 1. A substantial portion […]
In this article, we discuss the benefits of coding and case management (CM) collaboration – in particular, the value of CM documentation. By no means is this going to be an article about how case management should be cross-trained to learn coding. However, we believe there is value in coding professionals being able to engage […]
“Medicare Advantage plans have a unique and growing opportunity to address the needs of socioeconomically vulnerable populations and improve their health,” reports America’s Health Insurance Plans. More plans for individuals with low incomes, as well as targeted SDOH investments and initiatives, round out carrier approaches. On the benefits side, offerings such as meals, transportation, […]
The U.S. Department of Health and Human Services is releasing new funding aimed at helping schools reopen and to expand access to COVID-19 testing and treatments among underserved populations. On Wednesday, HHS made two funding announcements – to invest more than $12 billion to expand COVID-19 testing, as well as $150 million to increase access to monoclonal antibody therapeutic treatments […]
With concerns of COVID-19 having a disproportionate impact on certain individuals, such as minorities and the elderly, public health experts are requiring more detailed data, provided on a real-time basis – further supporting the reliability and integrity of data being central to healthcare. Though rates of new COVID-19 cases in the U.S. have somewhat stabilized, […]