MedLearn Publishing

Artificial intelligence (AI) has rapidly transitioned from a futuristic concept to an everyday workplace and personal productivity tool. What was once limited to technology companies and research laboratories is now embedded in email systems, smartphones, search engines, scheduling applications, customer service platforms, and office software. Increasingly, AI tools are becom...

Hospitals have spent years building documentation, coding, utilization review (UR), and quality programs around the inpatient encounter. The chart was reviewed, coded, billed, audited, appealed, and measured largely within a hospital’s four walls.

That framework is no longer enough.

With the Transforming Episode Accountability Model, known as TEAM, and the...

Recently I authored an article about how elimination of the Medicare Inpatient-Only List will lead to a reduction in surgical volumes that could negatively impact case mix index (CMI). This week, I want to continue exploring this topic by discussing how the inpatient population is changing, and why these shifts may limit the traditional ability of clinical documentation integ...

The Centers for Medicare & Medicaid Services (CMS) recently issued an Interim Final Rule with Comment (CMS-2454-IFC) implementing the Medicaid Community Engagement Requirement...

For lower extremity revascularization, utilizing angioplasty, stent placement, and/or atherectomy, what is the hierarchy of treatment for coding?

Codes for lower extremity revascularization are assigned according to a hierarchy of treatment for each of the three territories (iliac, femoral/popliteal, tibial/ peroneal). The order of least exte...