The CMS released the 2025 Proposed Inpatient Prospective Payment Rule yesterday. Some notable changes for the upcoming year include: 2.6% increa...
Overpayments Related to Improper HCCs Continue to Increase
The government is increasing enforcement efforts around proper risk adjustment coding (HCC coding). We continue to see regular audit reports det...
CMS Releases the 2024 IPPS Final Rule
The Medicare 2024 Final Inpatient Prospective Payment Rule has been published. Some notable changes for the upcoming year include: 3.1% increase in ...
OIG Work Plan Update Aimed at Medicare Advantage Risk Adjustment Coding
Today, the OIG issued their July Work Plan. The update is heavily focused on risk adjustment coding (Hierarchical Condition Category (HCC) Codin...
CMS Medicare Advantage Final Rule Takes Aim at Risk Adjustment Coding
Yesterday, CMS released the Medicare Advantage (MA) Risk Adjustment Data Validation Final Rule. The Final Rule is intended to strengthen the acc...
CMS Releases the 2023 IPPS Proposed
CMS released the 2023 Proposed Inpatient Prospective Payment Rule. The 1,786 page document includes some major changes for the upcoming year inc...
Increased Enforcement for Risk Adjustment Coding
Risk adjustment coding has the been source of several recent large, false claims act settlements and is also the topic of a recent OIG Work Plan Audit...
2022 ICD-10-CM/PCS CHANGES RAPIDLY APPROACHING
In less than one month, the 2022 edition of ICD-10-CM/PCS will become effective. This edition contains hundreds of ICD-10 code changes that incl...
2022 ICD-10 Coding Update
The 2022 edition of ICD-10 contains over 200 diagnosis coding changes. The CDC has just announced its release of the FY 2022 ICD-10-CM code set ...