It’s not unusual for CDI and inpatient coding teams to cite physician education and engagement as one of their top struggles in the field. In this article, read how the CDI team at Avera Health System turned to their query data to craft a focused education program and meet their physicians on the same page.
Through examples given within the wound care setting, Bobbie Starkey, RHIT, CCS-P , shows the importance of documentation and ICD-10-CM reporting to support hierarchical condition category (HCC) capture within the inpatient coding sphere. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC, MSHIM, RHIA, writes that CDI professionals and inpatient coders need to pay attention to the definitions and clinical indicators of acute kidney injury (AKI) to ensure proper ICD-10-CM reporting and reimbursement.
Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, reviews how critical thinking is important within the CDI and coding realm in order to enhance review accuracy and query rates and to help loosen reliance on technological tools such as encoders.
Sarah Nehring, RHIT, CCS, CCDS, writes that ICD-10-CM/PCS reporting for the cardiac system is complex and requires frequent review in order to report the most accurate codes. In this article, Nehring covers ICD-10-CM/PCS coding and clinical indicators for cardiogenic shock, intra-aortic balloon pumps, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Dawn Valdez, RN, LNC, CDIP, CCDS, says that the clinical indicators used to validate sepsis can also have other possible etiologies that could be equally responsible for the clinical indicators that are present—these are known as competing diagnoses.
Judith L. Kares, JD, details pertinant changes found in the fiscal year (FY) 2022 IPPS final rule, including payment rate updates and the repeal of the MS-DRG relative weight (RW) methodology.
In this article, Laurie L. Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC, reviews Coding Clinic , Second Quarter 2021, advice for reporting encephalopathy, a laparoscopic salpingo-oophorectomy, and more.
Howard Rodenberg, MD, MPH, CCDS, and Lynn Shay, CPHQ , say that making sense of varying COVID-19 case-mix index metrics is an important endeavor that will sometimes require a bit of DIY. In this article, they explain how they were able to unscramble their departments’ COVID-19 case-mix index data.
A recent study highlighted growing evidence that patients of all ages can develop type 1 diabetes after an acute COVID-19 infection. In this article, Susan Belley, RHIA, CPHQ, and Audrey Howard, RHIA, evaluate these findings as well as ICD-10-CM reporting for the two conditions.
Sarah Nehring, RHIT, CCS, CCDS , reviews ICD-10-CM reporting and clinical criteria for various types of heart failure including diastolic, systolic, hypertensive, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
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.
Judith L. Kares, JD, reviews potential updates found in the fiscal year (FY) 2022 IPPS proposed rule that pertain to quality programs for inpatient hospitals and changes to address existing inequities in the delivery of these services.
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.
Shelley C. Safian, PhD, RHIA, CCS-P, writes that inpatient Removals of a device from a lower bone may be performed less frequently than other procedures, which creates a need for more education on reporting ICD-10-PCS codes from table 0QP. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
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.
Approximately 1.5% of the general population sees a primary care physician each year for treatment of chest pain symptoms, according to Family Practice . In this article, Sarah Nehring, RHIT, CCS, CCDS , breaks down potentially confusing ICD-10-CM coding guidelines for chest pain and angina. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
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).
Medicare Recovery Auditors will review claims submitted by inpatient psychiatric facilities to ensure that billed services are medically reasonable and necessary, according to a recent Medicare Quarterly Provider Compliance Newsletter.
