A number of key events have recently occurred to leverage the necessary legislation, funding, and reimbursement required to implement sustainable social determinants of health (SDoH) programs.
Legislative focus is on the Social Determinants Accelerator Act, HR 2503. This bipartisan sponsored bill is geared to get over $25 million in planning grants and technical assistance directly to state, local, and tribal governments and communities, for the purpose of addressing the SDoH. Associations and organizations are stepping up to endorse the Act with considerable advocacy to advance the legislation; the massive list of entities is viewable on the Aligning for Health website. The bill was a major focus of the recent House Committee on Energy and Commerce hearing. Other social risk legislation received attention as well, including:
In addition, a bill to amend title XXVII (27) of the Public Health Service Act was discussed, which include SDoH interventions in medical loss ratio calculations. Links to each bill, and the Accelerator Act endorsement page, appear throughout this article.
The Gravity Project also continues to achieve success. You might remember that the Project advanced a multi-domain submission to the ICD-10-CM Coordination and Maintenance Virtual Meeting in March. We now have liftoff! The codes have been approved and will be implemented Oct. 1, 2021. This is exciting news for those who have been longing to expand the Z-code and subcategories that encompass education, food insecurity, and housing.
The list of enhancements is exciting to review; it includes, but is not limited to:
More recommendations are on the Gravity Project’s wish list. Additional codes are being refined and submitted for 2022 approval to address veteran status, transportation insecurity, financial insecurity, and material hardship. I’ll continue to provide updates as they become available on this topic and the Project’s important work. The full set of released terms can be viewed at the CDC’s National Center for Health Statistics, ICD-10-CM page, under section heading, “2022 release of ICD-10-CM.”
Our most recent Monitor Mondays Listeners Survey focused on “which potential ICD-10-CM-Z code submission listeners would want to see approved for 2022.” Time will tell what the priorities on the reimbursement horizon will be, although you can view the survey responses here.
Programming Note:
Listen to Ellen Fink-Samnick’s SDoH live reports Mondays on Monitor Mondays, 10 Eastern.
Well, this is the last RACmonitor news edition of the year, so it’s time for my annual Hirsch’s Heroes. As a reminder, last year my
The Centers for Medicare & Medicaid Services (CMS) has published several new proposed rules regarding Medicare payments for 2025. In addition to updating payment rates,
Please log in to your account to comment on this article.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Copyright © 2024 RACmonitor. Powered by MedLearn Media.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
