Trey La Charité, MD, FACP, SFHM, CCS, CCDS, writes that organizations that aren’t reviewing all in-hospital mortality cases are missing some tremendous opportunities to improve reimbursement and documentation.
Pediatric record reviews require a different skill set than those in the traditional adult acute care space. Often, those reviewing these specialized charts are islands within their overall CDI or coding department, acting as the sole pediatric chart reviewer. This article sheds light on how some have perfected these reviews within their department.
Howard Rodenberg, MD, MPH, CCDS , describes how internal reviews can be used to identify repeated coding errors and prevent payment penalties due to Patient Safety Indicators (PSI) and hospital-acquired conditions (HAC).
Joe Rivet, Esq, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO , summarizes findings from recent Office of Inspector General audits that highlight improper billing of high-level inpatient stays. He also outlines steps hospitals can take to prevent billing errors due to upcoding.
A recent Office of Inspector General audit estimates that Medicare improperly paid inpatient hospitals $267 million over a two-year period for transfer services incorrectly billed as discharges. Judith Kares, JD , analyzes documentation and billing rules for acute and post-acute transfers.
It’s always been easy to show financial return on investment for inpatient CDI endeavors, but the monetary value of outpatient programs is increasing dramatically year after year, making outpatient CDI reviews more attractive to many healthcare organizations.
The evolution of the role of clinical documentation integrity (CDI) specialists and their impact on coders has changed the landscape of inpatient coding departments. Learn about how to effectively collaborate with CDI professionals when conducting physician queries.
Though the adoption of outpatient CDI has been growing steadily over the years, it’s not always easy to prove the return on investment for such efforts.
Review quality reporting metrics such as length of stay and mortality indexes that you can use to assess patient outcomes and improve revenue cycle processes.
Ischemic heart disease has a multifactorial etiology and can be prevented from developing in populations primordially and in individuals at high risk by primary prevention.
