Hierarchical Condition Categories (HCC) are used to represent risk scores for patients on Medicare Advantage plans. Learn why it’s important for organizations to understand how HCCs are used across settings.
Monica Tyiska, MBA-PM, RHIA, CCS, CPC, CPMA, CHA, OHCC, CCP-P, offers advice for how organizations can improve hiring practices to ensure candidates from diverse backgrounds that represents the community are brought in.
Let’s face it: Our organizations are under tremendous scrutiny. As the healthcare dollar shrinks, all payers strive to minimize patient care expenses to maintain profit margins.
Strokes are complicated, which is why it is important for inpatient coders to be familiar with the brain’s anatomy and the clinical concepts of a stroke in order to report the most accurate ICD-10-CM codes.
Ischemic heart disease has a multifactorial etiology and can be prevented from developing in populations primordially and in individuals at high risk by primary prevention.
It’s common to see CDI job listings that require applicants to be registered nurses. Often an RN credential is not listed as being “preferred,” but required. There are risks, however, with only seeking candidates from this one background.
Audit defense is a key strategy to ensure coding and billing compliance and defend earned revenue. It’s more important than ever as the COVID-19 pandemic continues to drain hospital resources, but with HIM departments already stretched thin, it’s also more difficult than ever.
In 2005, the International Pediatric Sepsis Consensus Conference published definitions for sepsis, severe sepsis, and septic shock. Sepsis among children is defined as systemic inflammatory response syndrome (SIRS) associated with suspected or proven infection.
Facilities that are not leveraging CDI efforts for denials management and tracking denials as a key performance indicator (KPI) should consider doing so. Denials are the framework for identifying gaps in provider documentation and are a surefire approach to tailoring physician education that is meaningful.
