Tag: SDOH

Healthcare fraud in medical coding

Healthcare Fraud in Medical Coding: Upcoding, Unbundling, and Emerging Challenges

Healthcare fraud in medical coding, particularly through practices like upcoding and unbundling, has become a major concern for medical coding and billing professionals. A recent healthcare market research survey found that 90% of respondents view upcoding as a significant ethical challenge Upcoding involves assigning higher-level codes to medical services than are warranted, leading to inflated […]
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ICD-10-CM and PCS code

ICD-10-CM & PCS Code Changes Every Medical Coder Needs to Know

The recent ICD-10-CM and PCS code updates, let’s delve into a mixed bag of relevant topics. One significant change allows us to assign severity levels for certain eating disorder diagnoses. For anorexia nervosa (both restricting and binge eating/purging types), bulimia nervosa, and binge eating disorder, we can now specify the following severity levels: Mild Moderate […]
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ICD-10-CM-Update-Will-Change-the-Way-You-Code

ICD-10-CM Update Will Change the Way You Code

The April 2023 ICD-10-CM update adds many new codes for reporting external causes of injuries as well as expanded codes for reporting factors influencing health status more succinctly. But read the revised guideline for reporting social determinants of health (SDOH) before using these codes. Changes to the Tabular List In the ICD-10-CM Tabular List of […]
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Important-Changes-to-ICD-10-CM-Codes-and-Guidelines

Important Changes to ICD-10-CM Codes and Guidelines

New codes and updates become effective April 1. The updates to ICD-10-CM and ICD-10-PCS that become effective April 1 were released in mid-January. The updates include 42 new diagnosis codes. The significant changes to the ICD-10-CM guidelines are the following: A.19 – Code Assignment and Clinical Criteria This section has added a new sentence: “If […]
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New-Diagnosis-Codes-For-2023

New Diagnosis Codes For 2023 With A Focus On SDoH

On April 1, your revenue cycle will have additional diagnosis code options to further capture social determinants of health. The CDC just released upcoming changes to both the ICD-10-CM diagnosis code set and the official coding guidelines. The new changes include 42 diagnosis code additions, seven deletions, and one code revision. All changes will go […]
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New-Coding-Classifications-for-2023

New Coding Classifications for 2023

Update your facility-specific guidelines accordingly for 2023. Although the new calendar year is not the beginning of the federal fiscal year, there are coding classifications and terminologies that changed on Jan. 1, 2023. Current Procedural Terminology® (CPT) and Healthcare Current Procedure Coding System (HCPCS) have releases that went out on Jan. 1. There are also […]
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New ICD-10 Codes will help Physicians Tackle Social Barriers to Care

A new collaboration between the AMA and UnitedHealthcare will work to address the social and environmental factors that affect patients’ health by standardizing data collection on their social determinants of health (SDOH) to help address individuals’ unique needs that often go unmet. The two organizations are supporting the creation of 23 new ICD-10 codes related […]
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