Yvette M. DeVay, MHA, CPC, CPMA, CIC, CPC-I , reviews the anatomy of the brain and details treatments and surgeries associated with the brain and how to report them in ICD-10-CM/PCS.
Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, writes that even though CDI specialists are not coders, it’s important to learn the rules and guidelines that coders follow. CDI teams need to reference guidance and guidelines in their daily work to ensure documentation is clear, concise, and supportive of accurate code assignment true to the patient’s story.
In 2015, I wrote 44 appeal letters challenging DRG validation/coding denials. In 2016, I wrote 88 appeal letters. Last year, I penned 159. We already received more than 40 DRG validation denials in January of this year. Does this trend sound familiar?
The implementation of an EHR is a multifaceted, comprehensive project for healthcare organizations. Though it affects every department and function in some way, the impact on medical record coding may be the most profound and complicated, with some organizations reporting a 20% decrease in coding productivity after EHR implementation.
Traditionally, the Office of Inspector General (OIG) Work Plan is released annually with focus areas identified for the upcoming year. However, as of June 2017, the decision was made to update the plan on a monthly basis to promote transparency by demonstrating a continuous effort to ensure compliance.
The fiscal year (FY) 2018 ICD-10-CM changes have now been active for several months. Though the volume of new codes is relatively small compared to previous updates, the impact on reimbursement has the potential to be quite large.
Paul Evans, RHIA, CCDS, CCS, CCS-P, tackles the various characteristics of creating a query and says that while all portions of any program, such as education and metrics, are important, the proper formulation of a query represents the most important task for a CDI professional.
Osteoarthritis is the most common joint disorder in the United States and one of the leading causes of chronic pain and disability, according to the National Institutes of Health. In this article, Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, examines ICD-10-CM/PCS coding and associated guidance for this condition. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
James S. Kennedy, MD, CCS, CDIP, CCDS , reviews readmission rates and writes that if physicians learn the foundations of readmission measurement and implement some basic principles and workflows for reporting clinically accurate ICD-10-CM/PCS coding, hospitals can succeed with readmission measures.
Allen Frady, RN-BSN, CCDS, CCS, CRC, explains the value of tracking and understanding key performance indicators (KPI), and gives advice on how facilities can improve on its practices.
Medical necessity denials are commonly encountered in facilities. Complete understanding and utilization of the ICD-10-CM/PCS coding guidelines is imperative for coders and coding mangers to recognize how to avoid these denials. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
James S. Kennedy, MD, CCS, CCDS, CDIP, writes about potential coding compliance issues raised in the Office of Inspector General’s (OIG) Work Plan for providers to consider, including documentation and coding for severe malnutrition and bariatric surgery.
Did you know there is a coding competition? The second annual ICD-10 Coding Contest, sponsored by Central Learning, took place last summer, recruiting coders from all over the nation to participate in coding a total of 1,636 real-life medical cases.
As clinicians and coders invested in ICD-10-CM/PCS documentation and coding compliance, we’ve seen it all as it relates to the various approaches different hospital systems use to “optimize” or “maximize” their DRG-based case-mix index (CMI) or risk adjustment factor (RAF) scores based on Hierarchical Condition Categories (HCC).
The amount of energy it takes to stay up to date on all the relevant payment and coding updates can be overwhelming, taking valuable time away from daily record review duties and activities.
Review the provider documentation and operative report and consider the ICD-10-CM and ICD-10-PCS codes to be reported. See the answers and rationale to check your answers.
Clinical validity, documentation, and ICD-10-CM coding applicable to liver disease remains a great challenge to those invested in severity and risk-adjustment coding compliance.
