One of my favorite sayings when teaching clinical documentation integrity, as well as coding, is that a good lawyer knows the law, but a better lawyer knows the law, the judge, and the jury. In learning the judge and the jury, one of my favorite references is the Medicare Quarterly Provider Compliance Newsletter , an official CMS publication written in plain language that serves as a summary of how Medicare and its contractors interpret the Medicare rules, regulations, and policy statements.
All coders know that working with providers is not always a positive experience. It can be tough providing them education or getting responses from queries. Conversely, providers are busy and typically do not like anything to do with coding. When they hear coding they often take that to mean more work on their part.
Pneumonia discharges impact hospital payments under the Hospital Value-Based Purchasing Program, as well as the Hospital Readmission Reduction Program.
