The flu vaccine is changed each year based on the virus types that the Centers for Disease Control and Prevention estimates will be the most prevalent. Lori-Lynne Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC , reviews CPT and ICD-10-CM coding for this year’s flu vaccine and its administration.
Sarah Nehring, CCS, CCDS , writes that CDI and coding professionals must understand the guidelines for coding myocardial infarctions (MI) as well as the clinical difference between type 1 MIs and type 2 MIs so they can be clinically validated, queried, and reported effectively to avoid negative reimbursement ramifications. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
With the increased focus on clinical validation denials, more and more CDI professionals are finding themselves involved in the appeals-writing process and may initially feel a bit overwhelmed by the magnitude of the job. This article will provide you with best practices and appeal advice for those on the frontlines.
Julian Everett, RN, BSN, CDIP , reviews the background of the Program for Evaluating Payment Patterns Electronic Report (PEPPER) and says that even though the report is only made available through quality or chief financial departments, it is imperative CDI and coding staff have a seat at the table when discussing areas for improvement at a facility.
Ninety percent of hospital and inpatient organization leaders are considering outsourcing both clinical and non-clinical functions to achieve cost-efficiencies and succeed in value-based care models, according to a recent Black Book survey.
Q: Our coding department was told there were changes made for fiscal year (FY) 2020 when it comes to reporting healed/healing pressure ulcers and pressure-induced deep tissue damage. Can you explain any recent updates?
One of the most vexing challenges that CDI specialists have is how to engage physicians to completely and precisely document their patients’ conditions and treatments in the language required by ICD-10-CM, which is essential to risk adjustment.
Getting clean, compliant claims out the door is one of the foundations of a sound inpatient hospital. A robust process for handling claim edits and managing denials will go a long way toward supporting that goal.
As the cost of healthcare continues to skyrocket, payers are looking for ways to save and want to make sure that claims reflect correct information and that the care provided was clinically justified.
The 2020 update to the CPT Manua l includes extensive updates to cardiovascular codes, including new codes for pericardiocentesis and pericardial drainage, aortic grafting, and endovascular repair procedures.