William E. Haik, MD, FCCP, CDIP, a practicing pulmonologist and director of DRG Review, Inc., in Fort Walton Beach, Fla., says he first became interested in coded data in 1986 after a local newspaper published his hospital’s costs, length of stay, and mortality rates for simple pneumonia. At the time, he was the only pulmonologist in the local area. The patients he treated were often those with multiple comorbidities as well as gram-negative bacterial pneumonia who had been transferred from two smaller facilities in the county.
DRGs for procedures unrelated to the principal diagnosis shouldn't occur frequently. If they do, coding managers should take a closer look at coding compliance efforts to ensure accuracy and avoid costly audits.
Everyone knows that CCs and MCCs are under scrutiny these days. However, that doesn't mean hospitals should err on the side of caution when reporting these conditions. William E. Haik, MD, FCCP, CDIP, director of DRG Review, Inc., in Fort Walton Beach, Fla., provides several tips that coders can employ to look for clinical evidence in the record before querying for these targeted conditions.
As Lucile Packard Children's Hospital in Palo Alto, Calif., implemented its EHR, the dreaded problem of copy and paste documentation began to rear its ugly head.
After a six-month delay, the Recovery Auditor prepayment review demonstration program began in August 2012. The program continues through August 2015, at which point CMS will determine the potential for a national rollout.
The ICD-10-CM/PCS delay may give coders more time to learn the new system, but what does this mean for organizations that have already begun to prepare?
Coders play a crucial role in ensuring compliance, and the FY 2013 IPPS final rule , released August 1, gives them many reasons to showcase their skills.
