News
Ease the transition from V24 to V28 by knowing ICD-10-CM codes that map to CMS-HCCs
By Brian Murphy CMS document provides comprehensive list of HCCs in V28 The ongoing transition from CMS-HCC Version 24 (V24) to V28 has introduced several notable ICD-10-CM codes that now map to HCCs. These are available in an excel file on the CMS website. I thought I’d share a few that stand…
Read MoreThe work of mid-revenue professionals always comes down to values and character
By Brian Murphy A reminder that in the end it really is all about values and character. And taking responsibility for your actions. This is admittedly an easy concept to grasp, easy to write on a low-key Wednesday morning. But can be extraordinarily difficult to implement in practice, when the heat is on and pressure…
Read MoreUHC’s medical loss ratio an eye-opening reminder of impact of V28 of CMS-HCCs—for payers and providers
By Jason Jobes, VP of Solutions You want to read something scary? UHC said their 2024 full year medical loss ratio (MLR) was 85.5% compared to 83.2% in 2023. That 2.3 percentage point increase is nearly the same percent as the V28 impact in 2024. For those who have been following me over…
Read MoreNew sepsis aftercare code fills needed gap in long term care rendered to recovering patients
By Brian Murphy A reminder that we now have access to a new ICD-10-CM code for sepsis aftercare. Effective October 1, 2024, coders can report Z51.A: Encounter for Sepsis Aftercare. Z51.A was long in the making, needed to fill a gap in post-sepsis care. Sepsis is nasty and can result in long-term…
Read MoreExperts pitch obesity diagnosis overhaul, could alter CDI and coding work
By Brian Murphy There’s a new international effort afoot to revise the way physicians diagnose obesity. A clinical study published in The Lancet Diabetes & Endocrinology Journal, “Definition and Diagnostic Criteria of Clinical Obesity,” posits that obesity should be more than just high BMI, and recommends other measures including waist circumference, direct fat…
Read MoreCommit to trying new things (even just one) in 2025
By Brian Murphy Happy New Year! What resolutions are you hoping to implement in 2025? If you’re looking for some inspiration and ideas I recommend listening to my current episode of Off the Record (see link below). I take the top five lessons culled from a great lineup of guests and share them…
Read MoreSalaries improving for CDI specialist, according to ACDIS annual survey
By Brian Murphy ACDIS released its annual CDI Salary Survey. I recommend you go read it, it represents a ton of work and it’s an incredibly valuable resource for the industry. I’d be saying this even if I didn’t used to work for ACDIS. Link below. Here are some interesting data points…
Read MoreNorwood celebrates team excellence with Waymark Awards
By Brian Murphy Are you recognizing your people for their hard work? We do a pretty cool thing at Norwood (well, many cool things, but here’s one). The Waymark Awards. In the wilderness, Waymarks are trail markers that guide travelers and hikers, ensuring they’re on the right path. I am not…
Read MoreMS-DRG “upcoding” results in 2/3 of growth of high-intensity discharges, study says—but there’s more to the story
By Brian Murphy File this under, “Just pay $21 for the full article, Brian.” A study published by Health Affairs claims that “Upcoding Linked To Up To Two-Thirds Of Growth In Highest-Intensity Hospital Discharges In 5 States, 2011–19.” Link to paywall protected article below, though you can read the abstract for free.…
Read More“Career saboteurs” may be holding you back from job and life breakthroughs
By Brian Murphy What is holding you back in your career—and in life? Odds are it’s something within. Nicole Fox and I discussed this topic in candid fashion on a recent episode of the Off the Record podcast. Prior to the show Nicole sent me a short self-assessment that reveals your “career…
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