Coding and Documentation

Revenue integrity leaders looking to make an impact on the professional fee side of their organizations need to understand the unique opportunities

CMS is considering a significant change to how it pays for certain high-cost radiopharmaceuticals, as well as a sweeping new set of Conditions of Participation (CoPs) aimed at maternal health, and a slew of other changes in the 2025 Outpatient Prospective Payment System (OPPS) proposed rule.

Organizations could see a flood of new codes along with significant changes to the Medicare Shared Savings Program (MSSP) and coverage of telehealth services, according the 2025 Medicare Physician Fee Schedule (MPFS) proposed rule.

CMS recently updated an MLN Fact Sheet on Medicare Part D vaccines to clarify billing and formulary policies.

Celebrate your journey and acknowledge your success.

Consider how CMS’ proposed changes for 2025 could affect hospitals.

Catch up on proposed changes to MS-DRGs and reimbursement in the 2025 Inpatient Prospective Payment System (IPPS) proposed rule.

CMS is proposing to upgrade certain codes describing social determinants of health to better capture the effect of housing instability on beneficiaries, according to the fiscal year 2025 Inpatient Prospective Payment System (IPPS) proposed rule.

Apply these tips to start or improve revenue integrity programs for physician billing.

Learn how to develop and manage an outpatient-focused CDI program.