For coders, intraoperative serosal tears have become a topic of considerable angst. Are they reportable or not? Now that the AHA Central Office has given new guidance in both the

Is your facility or client missing out on correct payment due to inaccurate 7th Character Assignment for Injuries? The difference between “Sequela” and “Initial” encounter can result in underpayment to

In order for uncertain diagnoses to be eligible for reporting on inpatient admissions, these conditions must be documented as uncertain at the time of discharge.

CMS changes to Medicare Severity Diagnosis-Related Groups (MS-DRGs) for Fiscal Year (FY) 2023 are expected to be minimal; that is the good news.

For Evaluation and Management coders working in the ProFee setting, if you were coding in 2021 then you had to learn new E/M Documentation Guidelines for code assignment for encounters

Although we don’t like to think about it, complications of surgical and medical care are a reality of life. Some complications are attributed to medical care while others are related