The Office of Inspector General (OIG) recently released an audit report for Providence Medical Center that says some of the hospital’s inpatient records did not support the medical necessity for inpatient hospital services.
Howard Rodenberg, MD, MPH, CCDS , writes that ensuring the social determinants of health are appropriately documented within the medical record allows CDI and coding teams to capture the hard data needed to demonstrate the interactions among race, gender, ethnicity, and other key socioeconomic indicators with healthcare costs, utilization, and outcomes.
Review clinical indicators and query opportunities for acute respiratory failure, respiratory failure due to surgical procedures, and ventilator MS-DRGs. Frequently reviewing clinical indicators for these complicated diagnoses will ensure both proper coding and reimbursement. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Inpatient coding professionals must have a clinical understanding of COVID-19 and the disease process in order to accurately sequence diagnoses, code etiology and manifestations, and assign present on admission (POA) indicators. In this article, Audrey Howard, RHIA , and Susan Belley, RHIA, CPHQ, focus on coding issues related to POA indicators for the hospitalized, inpatient COVID-19 population.
Q: When two conditions are both present on admission, both meet definition to be the principal diagnosis (PDX), and are “equally treated,” my understanding is that the condition does not have to be "equally treated" in the sense of duration/frequency. Can you provide the actual verbiage of the coding rule and explain?
Malnutrition is notorious for its impact on hospital reimbursement. For example, in 2018 the Office of Inspector General (OIG) conducted an internal audit of the University of Wisconsin Hospitals and Clinics Authority. The audit revealed an overpayment of $9,569,586 for the billing of malnutrition.
Review coronary anatomy and CPT coding for aortic and iliac repairs, as well as selective procedures used to treat vascular occlusions in the lower extremities.
The 2021 update to the ICD-10-CM code set introduced 43 new codes to Chapter 3: Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. Review new codes for sickle-cell diseases, hemolytic anemias, and cytokine release syndrome.
In a year of unprecedented disruption and uncertainty, coding productivity managed to hold steady, according to the results of our 2020 Coding Productivity Survey. Learn how facilities adapted and how yours compares.
Our coding experts answer questions about CPT reporting for spinal decompression procedures, using medical decision-making to report E/M levels, and more.
