While the Affordable Care Act has led to fewer 30-day readmissions, this reduction in readmissions does not correlate with 30-day mortality rates, according to a recent JAMA study.
Mortality reviews pose a special challenge—not only does the CDI specialist need to know the ins and outs of severity of illness and risk of mortality, but the cases themselves are typically more complicated than an average hospital stay, making these essential reviews even more complex.
Now that the fiscal year 2018 ICD-10-CM/PCS codes have been implemented , James S. Kennedy, MD, CCS, CCDS, CDIP , reviews some of the compliance pitfalls that coders may encounter for diagnoses including Type 2 myocardial infarction, the pediatric Glasgow Coma Scale, and right heart failure.
Atrial fibrillation is the most common type of heart arrhythmia in the U.S. Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP , writes that an understanding of ICD-10-CM coding and sequencing for this condition is key, but coders still need to navigate ICD-10-PCS codes to capture the surgical services performed at the facility. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
Appeal writing, like most things in a hospital, is a learned skill. Keeping things simple, both in terms of the arguments constructed and the language used in the letters themselves, will prevent you from creating horrific monstrosities out of minor gremlins.
The 2018 update to the ICD-10-CM code set went into effect October 1, 2017, and features 728 total code changes, including 360 new, 142 deleted, and 226 revised codes.
If you have never participated in the ICD-10 Coordination and Maintenance proceedings, I highly suggest that you make it a goal for the future. I feel very maternal about some of the changes in ICD-10-CM which will be implemented October 1 because I participated in the formative meeting.
