Physicians can be a bit prickly at times. While this statement intentionally downplays the behavior of (hopefully) only a few doctors, I believe that most physicians are amenable to CDI concepts. While attempting to effect change in physician documentation patterns, I’ve learned many lessons from my medical staff and from other creative CDI colleagues.
The American Hospital Association recently published a Coding Clinic Advisor FAQ regarding ICD-10-CM coding for the novel coronavirus (COVID-19). This article takes a closer look at the main topics addressed in the FAQ, including ICD-10-CM coding for COVID-19 antibody testing, virus signs and symptoms, and comorbidities.
It’s been nearly three years since HCPro’s last survey dedicated to query practices . Since querying is a constant and continuous aspect of CDI work, a 16-question survey focused on physician queries was recently conducted. Because of the survey’s limited length, it concentrated primarily on productivity and compliance concerns.
Abnormalities in the brain and spinal cord can influence all body systems. Therefore, it is not surprising that diagnosis codes for neurologic disorders are widespread throughout the ICD-10-CM manual.
On May 11, CMS issued its inpatient prospective payment system (IPPS) proposed rule and policy changes for fiscal year (FY) 2021. The proposed rule includes ambitious policy changes showcasing CMS’ commitment to “transform the healthcare delivery system through competition and innovation while providing patients with better value and results.”
Prior to 1983, Medicare reimbursed based on actual charges that inpatient healthcare facilities billed (often referred to as “fee-for-service” payments). The more tests, procedures, and services ordered by physicians, the more an organization was paid. This created the potential for unnecessary or excessive services, contributing to rising healthcare costs and the possibility of depleting Medicare funds.
PEPPER is an acronym for the Program for Evaluating Payment Patterns Electronic Report . The PEPPER was originated by the Hospital Payment Monitoring Program (HPMP) and Quality Improvement Organizations.
For FY 2021, CMS projects the rate increase, together with other proposed changes to IPPS payment policies, will increase IPPS operating payments by approximately 2.5%. Proposed changes in uncompensated care payments, new technology add-on payments, and capital payments will decrease IPPS payments by approximately 0.4%, according to the proposed rule. Therefore, CMS estimates a total increase in overall IPPS payments of approximately 1.6%.
The following questions were answered by Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, HCS-D, director of HIM and coding for HCPro in Middleton, Massachusetts, and Yvette DeVay, MHA, CPC, CPMA, CIC, CPC-I, lead instructor for HCPro’s Medicare Boot Camp®—Physician Services Version.
