Coding and Documentation

New findings suggest upcoding is becoming a more common practice in emergency departments, urgent care centers, and physician offices. 

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.

Gan insights into how CDI can help shore up revenue integrity for office visits and ancillary services.

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.

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?

When first learning about modifier -25, revenue integrity professionals were likely given an example of a patient in a physician office being evalu

CMS is proposing a 2.4% increase in operating payments for acute care hospitals and weighing numerous modifications to quality and reporting programs tied to reimbursement.