Recently, we have seen a rise in the documented diagnosis of malnutrition at our inpatient facilities. Malnutrition is highly reviewed among auditors and just as commonly denied among payers. I want to share the most recent coding updates and best practice guidelines with you.
Although the HIM department plays a key role in the revenue cycle, too often it’s placed in a reactive position, limiting the department’s effectiveness. The HIM department can wind up locked in a cycle of cleaning up claims without being empowered to apply process improvements that would reduce errors and facilitate corrections.
Review clinical indicators for various types of encephalopathies including toxic or metabolic encephalopathy, hypertensive encephalopathy, and hepatic encephalopathy. Frequently reviewing clinical indicators for these complicated diagnoses will ensure both proper coding and reimbursement.
Both sepsis and malnutrition remain top denied diagnoses, and there is little sign of those denial rates slowing. Part one of this two-part series will take a closer look at malnutrition and sepsis criteria challenges, while part two will zero in on clinical validation and denial prevention for these two diagnoses.
Joe Rivet, Esq, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, looks at some of the new fiscal year (FY) 2021 ICD-10-CM codes and guidelines pertaining to COVID-19 and Chapter 1 of the ICD-10-CM manual: Certain infectious and parasitic diseases. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Clinical indicators for certain conditions or treatments frequently require greater completeness or specificity in ICD-10-CM, for which concurrent or retrospective query is often required.
Sarah Nehring, RHIT, CCS, CCDS, reviews several new COVID-19-related ICD-10-CM and ICD-10-PCS codes recently released by CMS that will become effective January 1. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Clinical indicators for certain conditions frequently require greater specificity in ICD-10-CM for which a query is often required. This article takes a closer look at clinical indicators and ICD-10-CM reporting for transient ischemic attack (TIA) and underlying causes and consequences. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Emmel Golden, MD, FCCP, CCDS , reviews three recent studies detailing sepsis trends in the U.S. and writes that now is a great time to shed light on how important complete, precise documentation and coding are to understanding the sepsis health challenges we face as a country.
Sydni Johnson, RN, BSN, CCDS , and Denice Piwowar, BSN, RN, CCDS , detail some basics of clinical validation and how to request supporting indicators of a documented diagnosis without questioning the provider’s judgment.
The HIM department plays a critical role in the revenue cycle, but it’s often placed in a reactive position, limiting its effectiveness. Learn how to improve operations by enhancing the HIM department’s involvement across the revenue cycle.
Alicia Kutzer, Esq., LL.M., M.H.A , reviews CMS’ Interim Final Rule with Request for Comments (IFC) concerning coverage, billing, and payment for COVID-19 vaccines and therapeutics. This guidance is imperative for inpatient hospitals to evaluate to ensure proper documentation and reimbursement.
Sarah A. Nehring, RHIT, CCS, CCDS, details ICD-10-CM reporting and clinical indicators for hepatic fibrosis, cirrhosis, and complications caused by cirrhosis such as ascites and spontaneous bacterial peritonitis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, RHIT, CCS, CCDS , details three significant changes to the ICD-10-CM tabular list Excludes notes that may prove valuable to hospitals in fiscal year (FY) 2021, including updates to Excludes notes for encephalopathy, toxic encephalopathy, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, writes that the better the CDI policies and procedures, the better CDI and inpatient coding departments can work efficiently together to achieve proper documentation, coding, and reimbursement.
Up to now, public health data collection has been mainly focused on adult COVID-19 patients, but we are beginning to see data indicating that COVID-19 is impacting children’s health as well. With more of the spotlight on pediatric COVID-19 diagnoses, it’s important to ensure proper documentation to help improve data collection.
