Tag Archives: medical coding

2024 ICD-10-CM Changes Are Weeks Away

Every year, CMS issues clarifications, additions and deletions to diagnosis codes that become effective on October 1st.  For 2024, CMS announced 395 new diagnosis codes, 25 deletions and 13 revisions. Although there are many changes in wording, synonyms and instructional … Read Full Post

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Standards for Your MRA Department – Consider the Source

Since 2004, our company’s MRA work has undergone significant evolution, and we’ve worked on everything from isolated projects for a one-time client, to daily or annual reviews and even to serve as a client’s MRA Department.  We presented some of … Read Full Post

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ICD-10-CM Changes for 2022

Changes to ICD-10-CM codes happen every year and 2022 (which coding-wise begins on October 1, 2021) is no different.  AAPC reports that 159 codes were added, 25 were deleted, and 27 ICD-10-CM codes were revised. This addendum from CMS explores … Read Full Post

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Supporting a Diagnosis of Angina Pectoris

In a primary care setting, we sometimes encounter patients who have been diagnosed with angina pectoris and are being followed by the primary care practitioner (PCP).  In this blog, we will share some of the most common issues regarding this … Read Full Post

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The ABCs of Coding

Imagine trying to have a conversation with someone who only speaks a foreign language and having no access to a translator.  Tough to do, right?  You’d need basic use and understanding of relevant words in the foreign language and your … Read Full Post

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Lessons from the Cigna/DOJ Lawsuit: Health Risk Appraisals (Part 2)

Last week’s first installment of this blog started our review of HRAs in the MRA environment.  Let’s continue searching for lessons to apply in your practice. A third issue with Cigna’s HRAs was the supposed expectation to capture all the … Read Full Post

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Lessons from the Cigna/DOJ Lawsuit: Health Risk Appraisals (Part 1)

This blog is the first in a series of lessons, or reminders, gleaned from the Department of Justice’s (DOJ) lawsuit against health insurer Cigna. The suit alleges that Cigna essentially committed fraud by reporting false information to CMS in a … Read Full Post

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The DOJ Targets MA Plans

The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) reported that a study conducted in 2019 revealed, “Unsupported risk adjusted payments are a major driver of improper payments in the Medicare Advantage (MA) … Read Full Post

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