Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same ...

As we reported in our Managed Care Newsletter in April 2020, the CARES Act passed by Congress last year provides for a 20% increase to the DRG weights in the Medicare Inpatient Prospective Payment ...

Effective April 1, 2020 through September 30, 2020, a new diagnosis code U07.1 was added to the ICD-10-CM code set for the novel coronavirus COVID-19: U07.1. The ICD-10-CM Official Coding and ...

Incorrect diagnosis codes from providers led to a $14 million windfall for some Medicare Advantage plans, a federal watchdog found. The Department of Health and Human Services’ Office of Inspector ...

CMS created three new MS-DRGs whose relative weights will be calibrated to account for hemodialysis costs and will therefore be excluded from additional ESRD payments. A version of this article was ...

Inpatient hospital stays have become more expensive to the Medicare program. It's a trend that began even before the COVID-19 pandemic. A new report from the Department of Health and Human Services' ...