ICD10monitor.com News and Information Services for Successful ICD-10 Implementation

Legal scholars, practitioners, and other observers have grappled with the legal dimensions of artificial intelligence (AI). As early as 1992, Solum discussed the case for considering AI to be a l...

https://icd10monitor.medlearn.com/defenses-against-ai-based-medicare-audits-part-ii/

As one of the co-chairs of the recent National Physician Advisors Conference (NPAC) in Coronado, Calif., I had a front-row seat to all that unfolded during a breathtaking spectacle of innovation ...

https://icd10monitor.medlearn.com/two-midnight-rule-among-topics-at-npac-2024/

It has been nearly 40 years since the U.S. Supreme Court indicated in Chevron v. Natural Resources Defense Council that courts should defer to an agency’s reasonable interpretation of an ambigu...

https://icd10monitor.medlearn.com/how-fish-are-related-to-medicare/

Last week was the National Physician Advisor Conference, and I want to thank all of those who stopped me and noted how useful they find Monitor Monday and RACmonitor news for keeping up on the la...

https://icd10monitor.medlearn.com/medicare-advantage-complaints-that-the-plans-dont-want-and-the-review-of-systems-that-wasnt-done/

Properly managed identity queues like roster management engines (RMEs) that mitigate errors and potential overlays lay the foundation for a well-maintained master person index (MPI) that minimize...

https://icd10monitor.medlearn.com/ten-tips-for-effective-patient-identity-queue-management/

The following topics have a place in your facility-specific coding guidelines: Personal History – Does the facility capture personal history codes? These codes may be helpful to pass medical ne...

https://icd10monitor.medlearn.com/update-your-facility-specific-coding-guidelines-part-3/

In its Inpatient Prospective Payment System (IPPS) Proposed Rule for the 2025 fiscal year (FY), the Centers for Medicare & Medicaid Services (CMS) is considering a change in the severity level de...

https://icd10monitor.medlearn.com/cms-ipps-proposed-rule-expansion-of-sdoh-designations-as-ccs/

The Centers for Medicare & Medicaid Services (CMS) has issued its 2025 Inpatient Prospective Payment System (IPPS) Proposed Rule, through which it proposes to change the severity designation for ...

https://icd10monitor.medlearn.com/the-ipps-proposed-rule-demonstrates-the-importance-of-sdoh/

What is the significance of using the term "first hour" in CPT code 94644, and how does this differ from other time-based codes that use the term "up to 1 hour"?

https://icd10monitor.medlearn.com/respiratory-question-for-the-week-of-april-22-2024/

What do the category III codes for digital pathology represent in 2023 and are there any new additional codes effective in 2024?

https://icd10monitor.medlearn.com/laboratory-question-for-the-week-of-april-22-2024/

If a patient has rheumatoid arthritis and comes in for a methotrexate injection, do we use the chemotherapy injection code?

https://icd10monitor.medlearn.com/general-question-for-the-week-of-april-22-2024/

If a practitioner orders a complete abdominal echo (76700) and the patient’s gallbladder has been removed, would we then charge for a limited (76705)?

https://icd10monitor.medlearn.com/radiology-question-for-the-week-of-april-22-2024/

Which CPT® code range should be used to report cardiac catheterization services for a patient with anomalous coronary arteries arising from any of the following circumstances including aorta or ...

https://icd10monitor.medlearn.com/cardiology-question-for-the-week-of-april-22-2024/

As we know, artificial intelligence (AI) is in the spotlight these days. It is being adopted in almost every sector of the economy. It is a commercial product, and the salespeople all argue that ...

https://icd10monitor.medlearn.com/emerging-legal-defenses-against-ai-assisted-medicare-audits-part-i/

Our first topic today is local coverage determinations (LCDs) and variation. I have written in the past about national and local coverage determinations, and I have complained about how it is inc...

https://icd10monitor.medlearn.com/remain-compliant-and-take-the-money/

Over the last few years, state ballot initiatives have emerged as a powerful tool in shaping healthcare policy across the country, and they appear to be gaining traction as a productive means of ...

https://icd10monitor.medlearn.com/evaluating-the-rise-of-state-ballot-initiatives-in-healthcare/

Since January 2021, the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) have accepted anonymous and con...

https://icd10monitor.medlearn.com/an-unsavory-business-practice-anonymous-accusations-of-fraud/

When it comes to healthcare policy, even seemingly minor adjustments can have significant ripple effects across the industry. The Centers for Medicare & Medicaid Services (CMS) recently unveiled ...

https://icd10monitor.medlearn.com/proposed-2025-ipps-rule-cms-targets-readmission-metrics/

Climate change is no longer a distant threat; it’s a current reality affecting all facets of life, including public health. As the planet warms, healthcare professionals face new challenges, fr...

https://icd10monitor.medlearn.com/the-front-line-of-climate-change-how-healthcare-coders-are-making-a-difference/

Last week I started a series on developing facility-specific coding guidelines. This series is based on an AHIMA practice brief by the same name. This practice brief was updated in December 2023....

https://icd10monitor.medlearn.com/updating-the-facility-specific-coding-guidelines-part-1-2/

There has been a kerfuffle on LinkedIn I would like to expound upon today. A colleague of mine, Siraj Khatib, was recently expressing his exasperation at clinical validation audits. He referred t...

https://icd10monitor.medlearn.com/can-only-a-clinician-perform-clinical-validation/

Federal officials are taking a TEAM approach to saving federal dollars on certain high-volume, high-cost surgical procedures with a new program embedded in the recent Proposed Rule for inpatient ...

https://icd10monitor.medlearn.com/feds-seeking-to-save-medicare-money-on-high-volume-high-cost-procedures/

Citing a growing emphasis on the social determinants of health (SDoH), federal officials this week unveiled a Proposed Rule for inpatient and long-term care hospitals (LTCHs) for the 2025 fiscal ...

https://icd10monitor.medlearn.com/cms-issues-proposed-rule-for-inpatient-hospitals-ltchs/

We received a patient from the ER who presented with severe pelvic pain. The HCG indicated pregnancy, but there was no intrauterine pregnancy so an ectopic is suspected. What is the correct code ...

https://icd10monitor.medlearn.com/radiology-question-for-the-week-of-april-15-2024/

Can we report medically necessary hydration in addition to blood transfusion?

https://icd10monitor.medlearn.com/general-question-for-the-week-of-april-15-2024/

What are some of the key MPFS reimbursement policies in 2024 that are pertinent to cardiology?

https://icd10monitor.medlearn.com/cardiology-question-for-the-week-of-april-15-2024/

When both an adequacy assessment and a definitive diagnosis are rendered during a cytopathology evaluation, which codes should be reported?

https://icd10monitor.medlearn.com/laboratory-question-for-the-week-of-april-15-2024/

When should code 95813 be reported during a sleep study, and what is the duration of monitoring that qualifies for this code?

https://icd10monitor.medlearn.com/respiratory-question-for-the-week-of-april-15-2024/

In 2024, a wave of new CPT® code changes swept charge masters, delivered by the American Medical Association (AMA), officially effective at the start of the new year. With a vast multitude of co...

https://icd10monitor.medlearn.com/insider-pro-tips-for-laboratory-and-pathology-coding-changes-make-waves-sweeping-deep-into-2024/

Dear Colleagues, Thanks to the American Health Information Management Association (AHIMA) which recreated the national celebration of Health Information Professional (HIP) week, we here at RACmon...

https://icd10monitor.medlearn.com/publishers-letter-celebrating-national-hip-week-april-15-19-2024/

First up, a totally unsubstantiated rumor. A Texas hospital has heard that one of their regional Medicare Advantage (MA) plans is going to start requiring a three-day inpatient stay to approve pa...

https://icd10monitor.medlearn.com/threading-the-needle-understanding-the-compliant-discharge-approach/

In a significant overhaul of Medicare Part D, set to take effect in 2025, beneficiaries are poised to experience a transformative change in how prescription drug benefits are structured and finan...

https://icd10monitor.medlearn.com/new-approach-to-medicare-part-d/

Recently, I was emailed a question from, presumably, a listener of Monitor Mondays. He wanted to know whether I had commented on the nationwide audits on all Inpatient Rehabilitation facilities (...

https://icd10monitor.medlearn.com/the-irf-nationwide-audit-could-reveal-prime-audit-targets/

Federal officials this week announced the rollout of a Final Rule for Medicare Part D prescription drug plans and the rapidly expanding Medicare Advantage (MA) program for the 2025 contract year,...

https://icd10monitor.medlearn.com/cms-rolls-out-part-d-ma-final-rule/

Today, we’re delving into an exciting and transformative area of healthcare: the personalized medicine revolution, particularly how it intersects with coding, documentation, and reimbursement i...

https://icd10monitor.medlearn.com/personalized-medicine-revolution-coding-documentation-and-reimbursement-in-the-genomic-era/

EDITOR’S NOTE: This series is based on the “Developing Facility-Specific Coding Guidelines” which is an AHIMA Practice Brief. This practice brief was updated in December 2023. It also conta...

https://icd10monitor.medlearn.com/updating-the-facility-specific-coding-guidelines-part-1/

As the globe prepares to commemorate World Health Day, a renowned expert in health information management, Lorraine Fernandes, is set to deliver valuable insights on key global health issues duri...

https://icd10monitor.medlearn.com/renowned-global-health-expert-lorraine-fernandes-to-mark-world-health-day-in-podcast/

The recent (February 21, 2024) cyberattack on Change Healthcare has caused a shutdown of most of its operations.  Change is one of the biggest clearinghouses in the industry, and handles the rou...

https://icd10monitor.medlearn.com/cyberattack-causes-jitters-deep-concern/

What is the typical duration of a polysomnography (PSG) procedure as described by codes 95810 and 95811?

https://icd10monitor.medlearn.com/respiratory-question-for-the-week-of-april-8-2024/

For 2024, which code is associated with assessing the balance of estrogen and progesterone in the vaginal squamous epithelium?

https://icd10monitor.medlearn.com/laboratory-question-for-the-week-of-april-8-2024/

What are the CMS market baskets used for?

https://icd10monitor.medlearn.com/cardiology-question-for-the-week-of-april-8-2024/

What happens when a physician converts an external drainage catheter to an internal-external drainage catheter. Is this an exchange? What code do we report for this in 2024?

https://icd10monitor.medlearn.com/radiology-question-for-the-week-of-april-8-2024/

We use 96360 and 96361 for hydration fluids administered in radiology. These codes often edit against the CT procedure code. What modifier would you recommend when coding for services provided in...

https://icd10monitor.medlearn.com/general-question-for-the-week-of-april-8-2024/

Dear Colleagues, One week amid 52 weeks will be dedicated to the tireless work being conducted by medical laboratory professionals and pathologists who continue to play such a vital role in Ameri...

https://icd10monitor.medlearn.com/publishers-letter-celebrating-national-lab-week-april-14-20-2024/

Have you or your coders ever gotten lost in the intricacies of coding for endoleaks in interventional radiology? Endoleaks, which occur post-graft placement to seal off an aneurysm, present uniqu...

https://icd10monitor.medlearn.com/expert-insight-into-endoleaks-and-lower-extremity-coding/

The recent UnitedHealthcare hack has left providers and payers in shock. In an era when digital information flows ceaselessly across the Internet, the protection of sensitive data, especially Per...

https://icd10monitor.medlearn.com/why-even-vpn-encryption-can-be-hacked-and-how-huge-insurance-providers-can-still-have-phi-data-stolen/

The bad news just keeps on coming for Martin’s Point Healthcare in Portland, Maine. The lawsuit includes a group of healthcare centers and also a health plan which operates Medicare Advantage p...

https://icd10monitor.medlearn.com/doj-intervenes-in-whistleblowers-false-claims-act-lawsuit-involving-martins-point-healthcare/

On March 27, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Inpatient Rehabilitation Facilities (IRFs) that would update payment policies for the 2025 fiscal year (...

https://icd10monitor.medlearn.com/cms-releases-proposed-rule-for-irfs-2/

It’s April and that means it’s time for the fiscal year 2025 proposed rules to start appearing. But the Centers for Medicare & Medicaid Services (CMS) this year jumped the gun and released th...

https://icd10monitor.medlearn.com/fy-2025-proposed-new-rules-and-outrageous-appeal-process/

Kaiser Permanente’s entity, Risant Health, has acquired Geisinger Health, completing a transaction that was finalized March 31 and announced today by both Risant Health and Geisinger. No terms ...

https://icd10monitor.medlearn.com/breaking-news-kaiser-permanentes-risant-health-acquires-geisinger/

Its name might be a little unwieldy, but somewhat ironically, federal officials expect it’ll actually make managing enrollment in and engagement with certain federal health programs far more st...

https://icd10monitor.medlearn.com/new-final-rule-aims-to-streamline-administrative-enrollment-for-medicaid-chip-bhp/

The End-Stage Renal Disease Treatment Choices (ETC) Model, introduced to improve patient outcomes and control healthcare costs, released their second annual evaluation on the impact of the ETC pr...

https://icd10monitor.medlearn.com/improving-dialysis-and-transplantation-assessing-the-impact-of-the-end-stage-renal-disease-treatment-choices-etc-model/

EDITOR’S NOTE: This is the second installment in a two-part series dealing with sepsis. Those of you who live in the adult world may not even be aware that the sepsis conundrum (i.e., Sepsis-2 ...

https://icd10monitor.medlearn.com/pediatric-sepsis-has-been-defined-experts-endorse-organ-dysfunction/

On March 27, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Inpatient Rehabilitation Facilities (IRFs) that would update payment policies for the 2025 fiscal year (...

https://icd10monitor.medlearn.com/cms-releases-proposed-rule-for-irfs/

What considerations should healthcare providers keep in mind regarding the medical necessity criteria when deciding whether to separately bill or bundle codes 88740 and 88741 for transcutaneous p...

https://icd10monitor.medlearn.com/laboratory-question-for-the-week-of-april-1-2024/

A computed tomography (CT) study of the temporal bones in the axial plane is followed by a CT study of the temporal bones in the coronal plane. Which code or codes should be reported?

https://icd10monitor.medlearn.com/radiology-question-for-the-week-of-april-1-2024/

How does the presence of unit of service edits and medically unlikely edits impact the billing practices for code 94375, particularly regarding the flow volume loop as an alternate method of calc...

https://icd10monitor.medlearn.com/respiratory-question-for-the-week-of-april-1-2024/

What is a CMS market basket?

https://icd10monitor.medlearn.com/cardiology-question-for-the-week-of-april-1-2024/

If a patient is receiving an IV infusion for hydration therapy and the stop time is not documented in the medical record, how should the service be coded?

https://icd10monitor.medlearn.com/general-question-for-the-week-of-april-1-2024/

EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring five individuals with profiles of their f...

https://icd10monitor.medlearn.com/late-career-change-never-too-late-to-reinvent-yourself/

EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring five individuals with profiles of their f...

https://icd10monitor.medlearn.com/the-death-of-an-actor/

EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring five individuals with profiles of their f...

https://icd10monitor.medlearn.com/a-tv-heartthrob-leads-to-a-real-life-starring-role/

Concern about hospitals sharing space has caused angst for several years. But as reiterated by Centers for Medicare & Medicaid Services (CMS) official David Wright, the Director of the Quality Sa...

https://icd10monitor.medlearn.com/understanding-the-wright-approach/

I promise I do not do this intentionally. Each week, I look for topics of interest and report on them. And you know they are as varied as can be. But this is now the third week in a row that I mu...

https://icd10monitor.medlearn.com/when-the-qio-answer-to-the-webinar-question-does-not-answer-the-question/

EDITOR’S NOTE:Jory Hatton, CEO for ClaraPrice, concludes his exclusive, three-part series for RACmonitor on the CMS Hospital Price Transparency rule. Avoiding a CMS (Centers for Medicare & Medi...

https://icd10monitor.medlearn.com/how-hospitals-can-avoid-a-price-transparency-audit-part-iii/

The looming federal shutdown was narrowly avoided this weekend after President Biden signed the $1.2 trillion spending package on Saturday. This package includes funding for the U.S. Department o...

https://icd10monitor.medlearn.com/busy-week-for-hhs-amid-looming-shutdown/

EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring five individuals with profiles of their f...

https://icd10monitor.medlearn.com/the-car-guy-who-became-a-doc/

A concept commonly discussed but not well-defined in healthcare is the necessity for a patient to have a “safe discharge plan.” Defining what constitutes “safe” in this context isn’t al...

https://icd10monitor.medlearn.com/understanding-the-safe-discharge-plan/

One of the goals of medical coding is documenting encounter notes to the highest degree of specificity. ICD-10-CM had some existing codes for documenting foreign bodies entering through a natural...

https://icd10monitor.medlearn.com/how-to-report-new-code-category-w44/

Today, I am going to begin a two-part look at sepsis, starting with the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) focus on Medicare Inpatient Hospital B...

https://icd10monitor.medlearn.com/oig-sets-sepsis-in-its-sights-part-1/

EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring five individuals with profiles of their f...

https://icd10monitor.medlearn.com/from-aspirational-shock-jock-to-real-world-medical-doc-james-kennedys-journey/

What are some examples of documentation indications for a medically necessary fluid replacement for hydration therapy?

https://icd10monitor.medlearn.com/general-question-for-the-week-of-march-25-2024/

If non-selective renal angiography is performed at the time of a diagnostic cardiac catheterization, should level ll HCPCS code 75625 be reported?

https://icd10monitor.medlearn.com/cardiology-question-for-the-week-of-march-25-2024/

How does the variability in normal ranges for breathing response to hypoxia impact the coding and billing process for related procedures, and what steps should healthcare facilities take to ensur...

https://icd10monitor.medlearn.com/respiratory-question-for-the-week-of-march-25-2024/

Which code should be used when enhancing cytology specimens to concentrate diagnostic material and remove background debris, using techniques like liquid-based slide preparation or monolayer meth...

https://icd10monitor.medlearn.com/laboratory-question-for-the-week-of-march-25-2024/

The patient presents with sternoclavicular (SC) joint pain, and a CT of the thorax (chest) with contrast is ordered. The radiology report describes the SC joint in its entirety, but no other surr...

https://icd10monitor.medlearn.com/radiology-question-for-the-week-of-march-25-2024/

Dear Colleagues, From quaint rural offices in windswept lands to sprawling metropolitan hospital teaching facilities at major U.S. universities, Saturday, March 30, 2024, is a day the country wil...

https://icd10monitor.medlearn.com/publishers-letter-celebrating-national-doctors-day-march-30/

EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring five individuals with profiles of their f...

https://icd10monitor.medlearn.com/medlearnmedia-honors-physicians-leading-up-to-national-doctors-day-on-march-30-2/

A couple of weeks ago, the Federal Trade Commission (FTC) held a three-hour webinar on the problems with private equity in healthcare. In this article, I want to briefly explain what private equi...

https://icd10monitor.medlearn.com/a-target-on-the-back-of-private-equity-in-healthcare/

In the realm of healthcare, the ideal of transparency has long been a beacon of trust and accountability. However, the journey towards price transparency in hospitals has been fraught with challe...

https://icd10monitor.medlearn.com/navigating-hospital-price-transparency-challenges/

I’d like to begin today with a quick shout-out to North Carolina State University, my undergraduate alma mater, for their stunning upset win over rival University of North Carolina in the Atlan...

https://icd10monitor.medlearn.com/we-won-a-reconsideration-success-story/

It is Cherry Blossom Week in the nation’s capital. Unfortunately, we’re coming off warm days last week, and the weather is starting to chill a bit. The political forecast in D.C. this week lo...

https://icd10monitor.medlearn.com/cherry-blossoms-and-government-shutdowns/

Let me start with another complaint about a Medicare contractor. A question recently came up on a user group about whether to provide the Important Message from Medicare (IMM) to patients with Me...

https://icd10monitor.medlearn.com/when-medicare-guidance-is-contradictory-where-do-you-turn/

EDITOR’S NOTE: In recognition of National Doctors’ Day, coming up at the end of the month, starting Monday, March 25, MedLearn Media will be honoring five individuals with profiles of their f...

https://icd10monitor.medlearn.com/medlearnmedia-honors-physicians-leading-up-to-national-doctors-day-on-march-30/

Last week the Biden-Harris Administration submitted their budget proposal for the Health Resources and Services Administration (HRSA) for the 2025 fiscal year, which outlines several key investme...

https://icd10monitor.medlearn.com/major-healthcare-initiatives-get-presidential-push/

Today, we’re venturing into a future where the worlds of ICD-10 coding and health informatics converge and transform in ways we are only beginning to imagine. Let’s dive into the evolving lan...

https://icd10monitor.medlearn.com/why-you-need-to-know-about-the-new-convergence/

The recent cyberattack on UnitedHealth Group’s subsidiary Change Healthcare, also known as Optum, has sent shockwaves through the medical community. This incident, which unfolded in late Februa...

https://icd10monitor.medlearn.com/have-you-been-chopd/

Although the effective date for billing Office and Outpatient (O/O) Evaluation and Management (E&M ) Visit Complexity Add-on Code G2211 was Jan. 1, the Centers for Medicare & Medicaid Services (C...

https://icd10monitor.medlearn.com/confusion-reigns-over-application-of-g2211/

Do we report Category III codes 0501T-0504T for the augmentative software analysis of a coronary CTA dataset?

https://icd10monitor.medlearn.com/radiology-question-for-the-week-of-march-18-2024/

What are the specific procedural codes associated with leukapheresis or lymphocytapheresis?

https://icd10monitor.medlearn.com/laboratory-question-for-the-week-of-march-18-2024/

How does the administration of a hypoxic challenge assist in the assessment and diagnosis of hypoxia, and what specific clinical scenarios warrant the use of this diagnostic approach?

https://icd10monitor.medlearn.com/respiratory-question-for-the-week-of-march-18-2024/

How is the following scenario coded? A patient has an SVG anastomosed to the LC obtuse marginal (OM). Next, this graft “jumps” to the RC posterolateral branch. Through the vein graft, the OM ...

https://icd10monitor.medlearn.com/cardiology-question-for-the-week-of-march-18-2024/

We are trying to find guidance for the coders when we have fluids and/or fluids with electrolytes that have been documented as running for hours and even days. Should all the hours really be repo...

https://icd10monitor.medlearn.com/general-question-for-the-week-of-march-18-2024/

Infusion services remain a vital component of medical treatment for patients across the nation, each area containing its own complexities that create challenges for coders and compliance professi...

https://icd10monitor.medlearn.com/mastering-medical-coding-for-monoclonal-antibody-immunization-insights-into-2024/

By now, you may have heard of or read something about the brutal cyberattack that hit UnitedHealth Group (UHG) subsidiary Change Healthcare. The scope of the breach was massive, and is said to ha...

https://icd10monitor.medlearn.com/the-cyberattack-shaking-healthcare-to-its-core/

Centers for Medicare & Medicaid Services (CMS) enforcement of new price transparency rules began in January, and ClaraPrice, which provides consulting services to hospital IT, revenue cycle, and ...

https://icd10monitor.medlearn.com/how-to-ensure-standardization-of-files-and-data-for-consumer-access-and-readability/

The recent data breach at Change Healthcare calls to mind the famous bank robber Willie Sutton, a.k.a. “Willie The Actor,” known for disguising himself a messenger, window cleaner, or bank gu...

https://icd10monitor.medlearn.com/data-hack-harkens-back-to-bank-robberies-2/

Loyal readers of RACmonitor will recall that two weeks ago, David Glaser was brutally honest with NGS about their, to say it kindly, poor performance dealing with a provider after an audit and su...

https://icd10monitor.medlearn.com/mac-misinterprets-ncd-denial-ensues/

EDITOR’S NOTE: The context for this article was conceptualized from a recent ACPA Town Hall meeting on observation metrics and an upcoming presentation by the author and Dr. Mohla at NPAC 2024 ...

https://icd10monitor.medlearn.com/understanding-the-connection-between-observation-rate-cmi/

When I ask facilities what their most common denials are, invariably, pneumonia makes the list. That was my personal experience when I handled clinical validation denials as a physician advisor. ...

https://icd10monitor.medlearn.com/how-to-prevent-pneumonia-drg-denials/