Coding Clinic , Fourth Quarter 2017, which became effective October 1, has interesting morsels affecting ICD-10-CM/PCS documentation and coding compliance.
Yes, I’ll admit it: I used to be one of those people. Before finding a great fit on a CDI dream team, I worked as a medical review examiner for a Medicare Administrative Contractor (MAC). During that time, I reviewed Part A claims for inpatient stays, therapy reviews, medications, and Recovery Auditor (RA) appeals—to name a few. Not only did I gain experience working with Medicare hospital claims, but I also got to see a little bit of how different facilities approach their denials.
According to the American Cancer Society, skin cancer is by far the most common type of cancer . Exposure to harmful ultraviolet (UV) rays from the sun without protection can cause skin cancer. UV rays can come from other sources as well, such as tanning beds and sun lamps. The number of skin cancer diagnoses has increased in the past few years.
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.
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.
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.
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.
You may be thinking that you’ve never heard of scleroderma. As a coder, we know to look at these big fancy words and break them down by their root words in order to get a clue of what we’re talking about.
One of the reasons that we all read Briefings in Coding Compliance Strategies is to maintain our competence and quality in coding and risk-adjustment principles as to anticipate how recovery auditors and accountability agents view our coded data. While a good compliance officer and attorney knows the law, the better one knows the law, the judge, and the jury.
The fiscal year (FY) 2018 IPPS final rule includes updates to payment rates and quality initiatives, but some of the most extensive changes pertain to MS-DRG classifications and relative weights.