Health Information Management

Claims Adjudication and Payer Rules under ICD-10

Rayellen Kishbach's picture

Because we process thousands of LCDs updates weekly for our Coding Suite, we often get some insights that we can share. With the implementation of ICD-10, a significant drop off in the number of local coverage determinations (LCDs) and coverage articles published by the Medicare Administrative Contractors (MACs) has occurred. (See table in the white paper link below). While this may be partly due to MAC consolidation, it has left providers with less guidance than before about the proper coding and billing of covered services.

Webinar Replay - Chargemaster Management & Data Integrity

As a living document, the chargemaster should be updated at a minimum on a quarterly basis, but there is need for daily changes: departments add and remove charges, payers update contracts, and a regulatory environment in flux demands constant updates. Healthcare organizations know they can improve the integrity of their revenue programs through ongoing review and maintenance of their chargemaster, but many struggle with best practices in the face of complexity.

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