Nearly 75% of participating hospitals nationwide with RA activity reported receiving at least one underpayment determination, according to the AHA RACTrac survey, fourth quarter 2012, released in March. Sixty-nine percent of hospitals with underpayment determinations cited incorrect MS-DRG as a reason for the underpayment.
Researcher Bill Rudman, PhD, RHIA, says he didn't fully understand the implications of codes that coders assign until he was sitting around a table with several criminal justice officials who said that coded data helps reduce violent crimes and recidivism.
The ICD-9-CM guidelines state that it's unusual for two or more diagnoses to meet the definition of principal diagnosis. However, coders know this isn't exactly true, as the scenario tends to occur frequently.
ICD-10-CM/PCS incorporates laterality, acuity, anatomical specificity, and a slew of additional combination and complication codes. Who will submit queries when this information is missing in a medical record? Will coders or CDI specialists take on this role? Perhaps it might be a combination of the two.
Inpatient-only procedures are those that CMS has determined providers must perform on an inpatient basis because they are invasive and require at least 24 hours of postoperative recovery time or monitoring.
