Hospitals decide how much to bill Medicare for your care based on your diagnostic-related group (DRG). They then charge Medicare based on your DRG tier instead of separately for each of your medical ...

Diagnostic-related groups (DRGs) are how Medicare and some other health insurance companies categorize hospital costs to determine how much to pay for a hospital stay. With DRGs, the payment amount ...

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 ...

In the complicated world of hospital billing, there’s a fine line between maximizing reimbursement and gaming the system. A new study shows a troubling trend as hospitals increasingly code for “sicker ...

CorroHealth reveals new technology dedicated to optimizing DRG and Revenue Integrity. With the healthcare industry grappling with a shortage of skilled professionals and payer denials, including DRG ...

The U.S. Medicare draft inpatient rule for fiscal 2026 discusses a number of coding proposals, although the agency seems disinclined to go along with a proposal to increase payment rates for TAVR ...

WASHINGTON, April 2 -- The Health and Human Services Inspector General issued the following audit report (No. A-07-19-01192) on March 2023 entitled "Medicare Advantage Compliance Audit of Specific ...

Editor’s Note: A proposed rule posted to the federal government website Regulations.gov on May 9, 2016 by the Centers for Medicare and Medicaid Services (CMS) received 1,522 mailed or emailed comments ...