Mortality reviews pose a special challenge—not only does the CDI specialist need to know the ins and outs of severity of illness and risk of mortality, but the cases themselves are typically more complicated than an average hospital stay, making these essential reviews even more complex.
Appeal writing, like most things in a hospital, is a learned skill. Keeping things simple, both in terms of the arguments constructed and the language used in the letters themselves, will prevent you from creating horrific monstrosities out of minor gremlins.
The 2018 update to the ICD-10-CM code set went into effect October 1, 2017, and features 728 total code changes, including 360 new, 142 deleted, and 226 revised codes.
Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
Now that the fiscal year (FY) 2018 IPPS Final Rule , the 2018 ICD-10-CM Official Guidelines for Coding and Reporting , and Coding Clinic , Third Quarter 2017, have been released, let’s continue to process some interesting dynamics that warrant our consideration in documentation and coding compliance.
If you have never participated in the ICD-10 Coordination and Maintenance proceedings, I highly suggest that you make it a goal for the future. I feel very maternal about some of the changes in ICD-10-CM which will be implemented October 1 because I participated in the formative meeting.
In August, CMS released the fiscal year (FY) 2018 IPPS final rule which featured updates to various quality initiatives, annual payment updates for inpatient services, and an extensive amount of now-annual ICD-10-PCS code additions, deletions, and revisions.