AS Malaysians grapple with rising healthcare costs and increasing insurance premiums, the government is exploring a new payment model aimed at curbing medical inflation, which is scheduled to be ...

In an effort to provide helpful information to providers, CMS has released a special edition MedLearn Matters (MLN) article that disseminates diagnosis-related group (DRG) coding vulnerabilities for ...

Diagnosis-related group coding determines eligibility for many Medicare bundled payment initiatives. This approach excluded many patients with chronic obstructive pulmonary disease likely to benefit ...

CMS suggests 1,495 total changes to the ICD-10-CM diagnosis code set in the FY 2023 IPPS proposed rule. Brain illness and injury, with a focus on dementia-related diagnoses, occupy a high volume of ...

Diagnosis-based payment systems can create incentives to upcode patients to a higher level of severity to increase payment. In some instances, upcoding can be a form of fraud if providers code ...