Internal audits can reveal inconsistencies in provider documentation and coding, reporting errors, and fraudulent billing practices. Review internal auditing basics and advice from regulatory experts on how to effectively educate providers on audit findings. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, CCS, CCDS, says that the last thing a query writer wants is to provoke a defensive response, but in the current healthcare environment, CDI specialists, clinical, and inpatient coding staff need to think defensively. In this article, Nehring outlines five items to remember when it comes to defendable queries, documentation, and coding.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O, HCS-D, reviews the 2020 ICD-10-CM code changes for atrial fibrillation, as well as the clinical background and ICD-10-PCS reporting for related procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS is finalizing its proposal to create two new MS-DRGs for endovascular cardiac valve procedures with and without MCC, according to the fiscal year 2020 IPPS final rule.
Q: We recently had a patient who was admitted with sepsis and the physician documented sepsis, a urinary tract infection (UTI) related to a chronic Foley catheter, and pneumonia. Can we report sepsis first instead of the complication code, or is the complication always first?
Peggy S. Blue, MPH, CCS, CCS-P, CPC, CEMC, writes that one of the most interesting aspects of the ICD-10-CM code update for fiscal year (FY) 2020 was CMS’ proposal to change the severity assignment for many of these codes. In this article, Blue compares the severity changes that were suggested in the FY 2020 IPPS proposed rule with the designations that were actually finalized.
Q: Would it be appropriate to query the provider for clarification if documentation for an orbital fracture doesn’t specify the location of the fracture and whether it is open or closed?
The 2020 CPT update added new codes for the preparation and insertion of drug delivery devices, dry needling, and anesthetic nerve injection administration. Familiarize yourself with these and other updates before they go into effect January 1. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Gastrointestinal cancer is the fourth most common cancer in the U.S., according to the National Cancer Institute. Shelley C. Safian, PhD, RHIA, CCS-P, CPC-I, COC , writes about ICD-10-CM coding for colon cancer screening and CPT coding for diagnostic colonoscopies.
If payment updates in the 2020 Medicare Physician Fee Schedule proposed rule are finalized, they will significantly impact physician reimbursement for x-ray and E/M CPT codes, among others. Review payment proposals and the specialties that would see the greatest impact.
