Clinical documentation improvement (CDI) specialists, in theory, bridge the gap between physicians and coders. However, CDI and coding teams are often educated separately and work apart from each other.
One of the primary difficulties in achieving uniformity of code assignment is that, in some circumstances, selecting the principal diagnosis is believed to be up to the individual coder or CDI specialist. Let’s take a closer look at the 2017 ICD-10-CM Official Guidelines for Coding and Reporting to understand whether this is really the case.
CMS released the fiscal year 2018 IPPS proposed rule in April, and with it came a bevy of new potential ICD-10-CM codes. The update includes a total of 406 proposed new, revised, and deleted codes to be implemented October 1, 2017.
Traditionally, the OPPS rulemaking cycle has been the main vehicle for changes to outpatient coding and billing regulations and policy that hospitals need to pay attention to. But increasingly, CMS has been introducing or discussing changes relevant to outpatient hospitals beyond the scope of the OPPS rules.
Q: When reporting multiple separate infusions of the same substance or drug provided through the same IV site during one visit, should we add up the total time and then report the appropriate codes?
CMS released four new resources in early April on the Merit-based Incentive Payment System, one of two new payment options under the Quality Payment Program initiative created by the Medicare Access and CHIP Reauthorization Act.
April marks sexually transmitted infections month, and Peggy S. Blue, MPH, CPC, CCS-P, CEMC , gets in the spirit by breaking down the staging, diagnosis, and treatment of syphilis before examining how to code the disease in ICD-10-CM. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
CMS released the fiscal year 2018 IPPS proposed rule April 14, and with it came a bevy of new potential ICD-10-CM codes. Explore the new additions to the ophthalmologic, non-pressure chronic ulcer, maternity and external cause codes ahead of implementation October 1.
HCCs are the basis for risk adjustments for reimbursement models like Medicare Advantage, accountable care organizations, and other value-based purchasing measures such as Medicare Spending Per Beneficiary. Poor understanding and application of HCCs mean that a hospital’s patients may be much sicker in reality than they appear to be on paper, and that will hit reimbursement hard.
Coding Clinic for ICD-10-CM/PCS , First Quarter 2017, which became effective March 15, provides interesting perspectives that may be useful in our deliberations with payers or Recovery Auditors. Let’s process some of its guidance.
On Friday, April 14, CMS released the fiscal year 2018 IPPS proposed rule with updates to quality initiatives and 2018 ICD-10-PCS and ICD-10-CM code proposals.
Query practices have changed a lot over the years. With so many shifts, coders and clinical documentation specialists may need to take a step back and take stock of the changes they’ve worked through, reassessing current practices against industry recommendations and shoring up policies to prevent well-known pitfalls.
Ghazal Irfan, RHIA, writes about healthcare’s shift from fee-for-service to pay-for-performance, volume-based care to value-based reimbursement, and case-mix index to outcome measures, and how your facility can achieve compliant coding practices among these changes.
Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CRC, CCDS, discusses the reporting of alcoholism, its key documentation details, and its effect on MS-DRGs in ICD-10. Note: To access this free article, make sure you first register here if you do not have a paid subscription.
