Revenue integrity professionals need to understand how new elements in the healthcare industry, from changing regulations to advances in technology, are affecting hospital reimbursement, compliance, and other key revenue integrity priorities. They need to stay not just current but ahead of the...Read More »
Gain insights into CMS’ and the Office of Inspector General’s audit targets and learn how to put this knowledge to work at your organization.Read More »
CMS recently published the April 2025 Outpatient Prospective Payment System (OPPS) update to highlight coding changes for skin substitute products that took effect on April 1.Read More »
Q: If a provider documents sepsis with acute kidney injury but does not explicitly link the two conditions, should they be queried to prevent the claim from being denied?Read More »
When first learning about modifier -25, revenue integrity professionals were likely given an example of a patient in a physician office being evaluated for a minor health issue who asks to be examined for an unrelated problem at the end of the appointment.
