Every year, the Centers for Medicare and Medicaid Services (CMS) makes revisions, additions and deletions to the coding guidelines that healthcare organizations and practices use for reporting, billing and reimbursement. The guidelines for 2024 include a number of new guidelines dealing with social determinants of health (SDOH) issues. It is crucial for practices to fully understand all the guideline updates for accurate reporting and maximized reimbursement. In the next two episodes, Tomas discusses the latest coding guidelines with two leading clinical documentation experts.

Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient

Guests:
Sheila Bowlds, MBA
Associate Principal
Clinical Documentation Improvement
Vizient

Jim Tamburini, BS, RHIT, CCS, CSS-P, CDIP
Senior Consulting Director 
Clinical Documentation Improvement
Vizient

Show Notes:

[01:39] Background and explanation of CMS coding updates

[03:19] When changes go into effect

[03:37] Impact on providers and hospitals

[04:42] Number of diagnosis and procedure codes added, deleted and revised

[06:48] Specificity drives the documentation

[07:26] Changes to complications/comorbidities (CCs) and Major complications/comorbidities (MCCs)

[11:58] Changes to DRGs and MS-DRGs

 

Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Sheila’s email: sheila.bowlds@vizientinc.com

Jim’s email: james.tamburini@vizientinc.com

ICD-10-CM Official Guidelines for Coding and Reporting: https://www.cms.gov/files/document/fy-2024-icd-10-cm-coding-guidelines.pdf

 

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