If you've ever read an issue of HCPro's flagship newsletter HIM Briefings, if you've ever picked up an issue of Briefings on Coding Compliance Strategies and turned to the column "Clinically Speaking," if you've been a regular listener of HCPro's HIM or CDI audio conferences or webinars, if you're a member of the Association of Clinical Documentation Improvement Specialists (ACDIS) and subscribe to the "CDI Talk" newsgroup or listen to the ACDIS quarterly conference calls, chances are you've encountered the phenomenon known as Robert Gold, MD.
Allow me to introduce myself as the new columnist for the "Clinically Speaking" section of Briefings on Coding Compliance Strategies after the recent passing of Dr. Bob Gold. My hope is that this column will continue his legacy of helping you promote complete, precise, and clinically congruent ICD-10-CM/PCS code assignments resulting in defendable DRG assignment and applicable severity and risk adjustment. Thank you for this privilege of writing to you; I solicit your feedback and advice.
The FY 2017 IPPS proposed rule released April 27 is replete with modifications and expansions to claims-based quality and cost outcome measures. Although many of these proposed changes are for future fiscal years, ICD-10 codes reported for current discharges will impact the future financial performance for our organizations.
On April 18, CMS issued its anticipated IPPS proposed rule for FY 2017. This year's proposed rule is very dense, including multiple coding fixes and updates, changes to payment provisions, quality updates, and even something for utilization review.
The FY 2017 IPPS proposed rule includes updates to payment rates and quality initiatives, but some of the most extensive changes pertain to proposals for certain MS-DRG classifications and relative weights.
ICD-10 has brought us I10 (essential [primary] hypertension). Some of us thought "That's a relief," while some of us thought "That's a travesty." I am one of the latter.
In February 2016, just four months after ICD-10 go-live, sister publication HIM Briefings (formerly Medical Records Briefing ) asked a range of healthcare professionals to weigh in on their productivity in ICD-9 versus ICD-10.
Clinical documentation and coding has a significant impact on value-based quality outcome performance. Such outcomes include risk-adjusted mortality, readmission, patient safety, complication rates, and cost efficiency measures.
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)¹ as published on February 23 in the Journal of the American Medical Association represents a radical departure from the prior sepsis definitions in 1991² (identified as Sepsis-1) and 2001³ (identified as Sepsis-2) and subsequent Surviving Sepsis Campaign (SSC) guidelines through 2015.
There have been some significant changes in documentation needs for diseases of the brain since October 2015. These can affect accurate patient data as well as providing information for the treatment needs of the patients both during a hospital stay and afterwards. They will enable patient information to be available to all providers and ensure that you get paid appropriately for the complexity of the patients under your care.
