It’s that time of year again – when HIM directors, hospital administrators, and coding managers begin to wonder just how they will be affected come October 1.
The Medicare Outpatient Observation Notice (MOON) finally went into effect after a bumpy start. The MOON was originally set to go into effect August 2016, but the draft version was only released for comment at the beginning of that month.
Now that the fiscal year 2018 ICD-10-CM/PCS codes have been released , let’s consider some of the compliance pitfalls, booby traps, and opportunities that await coders when these new codes are implemented on October 1.
James S. Kennedy, MD, CCS, CDIP , explains how ICD-10-CM addresses kidney illness and advises on how to ensure documentation and coding integrity through certain challenges including risk-adjustment methodologies and functional versus anatomic diagnoses.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, writes that coding for skin cancers requires understanding the guidelines as well as knowledge of how the conditions are classified in the ICD-10-CM manual. 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 documentation improvement in the outpatient arena, Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, CDIP, COBGC, shares her tips for proving medical necessity on claims.
Daniel E. Catalano, MD, FACOG, says that from the CDI perspective, the ability to communicate pediatric severity of illness is complicated by the fact that pediatricians have a lexicon that is not well captured in ICD-10-CM. This, he writes, is especially true for pediatric cardiology.
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS , explains that as a coding manager, whether your inpatient team is on-site, off-site, or remote, creating the appropriate environment and selecting proper locations are key to any successful team. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
James S. Kennedy, MD, CCS, CDIP, writes that while you might have thought you’ve finally mastered coding compliance with DRGs and quality measures, now it is time to learn the compliance risks and opportunities with a new risk-adjustment method: Hierarchical Condition Categories.
