News
STEMI and NSTEMI may be giving way to occlusion MI (OMI) in clinical literature
By Brian Murphy Could STEMI change to OMI? A recent study published in the journal JACC: Advances of ST elevation MI (STEMI) and non-STEMI (NSTEMI) concludes the time has come. STEMI and NSTEMI are familiar terms for coding and CDI professionals. But the study says they are often inadequate for accurate diagnosis,…
Read MoreWhat actually passed with the new TEAM model in 2025 IPPS final rule?
By Brian Murphy What actually passed with the new TEAM model—and what does it mean for your organization? Somewhat lost amid the sea of new regulations and transmittals is CMS’ passage of a new mandatory alternative payment model called the Transforming Episode Accountability Model (TEAM) in the 2025 IPPS final rule. Per…
Read MoreMake the new CMS quality measure Thirty-Day Risk Standardized Death Rate a major priority in your CDI, coding efforts
By Brian Murphy Among the many ethical challenges CDI professionals face is pressure to make their organizations and/or providers look better on paper, through elimination of diagnoses that might trigger a patient safety indicator (PSI) or other quality measure. In some organizations the pressure to improve quality scores is stronger than CC/MCC/HCC capture. …
Read MoreUniversity of Colorado Health $23M settlement a red flag for over-reliance on automated coding
By Jason Jobes FALSE CLAIMS ALERT: University of Colorado Health has agreed to pay the United States $23M for false claims tied to E/M levels billed for emergency department services. At its core technology makes good—or bad—processes move faster. Thanks for taking time to read this post. If you find this valuable, please send…
Read MoreHCC coding compliance Q&A
Norwood hosted a webinar on Nov. 12, Navigating Regulatory Waters in Risk Adjustment: The OIG, False Claims Act, and HCC Findings.” During the show we got several excellent comments in the Q&A chat. Below is an excerpted and lightly edited transcription. You can view an on-demand recording of the full program here: https://my.demio.com/ref/o0WT9l8jMiof0v8L Question: We…
Read MoreUpcoding, AI, audits, ICD-11 all keeping medical coders up at night, according to HIM survey
By Brian Murphy What’s keeping medical coders up at night? Besides a Halloween hangover of too many scary movies and candy? Topping the list are upcoding pressures, artificial intelligence, audits, value-based care coding, and ICD-11 (yikes—scary). Thanks to Becker’s Hospital Review for offering up this helpful summary of an Oct. 18 survey…
Read MoreBack from Camp Norwood, grateful and recharged
By Brian Murphy Do you remember those camping trips you took when you were a kid? Sleeping in tents, cold and uncomfortable, and maybe a little sad to be so far from home? Camp Norwood was … not any of that. Except for far from home (at least for those of us who…
Read MoreEight frequently misdiagnosed conditions can be rectified with good CDI, coding practices
By Brian Murphy What conditions are most frequently misdiagnosed, leading to patient harm? A study by the general internal medicine team at Brigham and Women’s Hospital and Harvard Medical School in Boston (yay, my backyard! No Harvard jokes please) found that 1 in 14 general medicine patients (7%) experience harm from diagnostic errors.…
Read MoreRemote patient monitoring sees huge utilization increase, but corresponding regulatory spotlight
By Brian Murphy Remote patient monitoring has incredible potential to improve the health of our population… but many providers aren’t billing it correctly, raising the specter of inappropriate utilization or fraud, waste, and abuse. Remote patient monitoring is the use of devices (think blood pressure cuffs, CPAP machines, insulin pumps, etc.) that a…
Read MoreNew pediatric respiratory failure white paper published for CDI specialists
By Brian Murphy Pediatric clinicians (of which I’m definitely not one, but I listen well) will frequently tell you: Children are not just little adults. That goes for clinical criteria used to diagnose pediatric conditions, and associated CDI and coding work. And in particular, respiratory failure. I was very glad to see…
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