Departmental silos are prevalent in the healthcare world and can lead to unvoiced frustrations and counterproductive work. This article reviews how different organizations have various approaches to breaking down these walls.
Susan Belley, M.Ed., RHIA, CPHQ, and Audrey Howard, RHIA, write that a majority of inpatients during this omicron surge are admitted for reasons other than COVID-19 and are incidentally found to be COVID-19-positive—making this an opportune time to review ICD-10-CM reporting for COVID-19 as a secondary diagnosis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Many physicians are not entirely aware of the denials landscape and their involvement in it is often something they never anticipated. Educating physicians on their role in coding denials is important as it will help ensure proper reimbursement. Part two of this two-part series discusses involving physicians in administrative law judge appeals and monitoring success rates.
Anneleah Williams-Bridges, MS, MBCA, RHIA, CCS, CCS-P, CCDS, RH-CBS, LIA, says that until recently, many organizations have solely used their coding and CDI resources to strengthen the capture of CCs/MCCs, severity of illness/risk of mortality scores, and MS-DRG validation; however, facilities that are not leveraging these teams for denials management and tracking denials as a key performance indicator should consider doing so.
Jillian Harrington, MHA, CPC, CPC-I, CPC-P, CCS, CCS-P, CEMC, MHP, writes that in order to ensure proper coding, documentation, and reimbursement, it’s great practice to have inpatient coding and CDI teams review querying procedures yearly. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Many physicians are not entirely aware of the denials landscape and their involvement in it is often something that they never anticipated. Educating physicians on their role in coding denials is important as it will help ensure proper reimbursement. Part one of this two-part series discusses how to make time for proactive education.
Most risk adjustment models use ICD-10-CM codes to identify patients who are considered “risky” by healthcare insurance companies. The process of risk adjustment is used to predict costs linked to care delivery and quality reporting, which is why thorough knowledge of risk adjustment is important for hospitals to ensure proper quality reporting.
Sarah A. Nehring, RHIT, CCS, CCDS , writes that with new COVID-19 codes coming in April 2022, now is a good time to review these updates as well as an ICD-10-CM code that was previously released in an April update: electronic cigarette, or vaping, product use-associated lung injury (EVALI). Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Patient safety and quality of care are forerunning concerns for organizations today. Not only do we want to ensure our patients are receiving high-quality care, we want to ensure care is safe and effective. We need to examine how and when we evaluate that quality of care, however, in order to remain ethical and compliant.
Inpatient coders and CDI specialists are usually familiar with ICD-10-CM coding for diabetes mellitus and Cushing’s syndrome. However, they may need a refresher on ICD-10-CM coding for less common endocrine disorders. This article breaks down endocrine anatomy and physiology, and ICD-10-CM coding for thyroid, parathyroid, adrenal, and pineal irregularities.
According to Deanne Wilk, BSN, RN, CCDS, CDIP, CCDS-O, CCS, patient safety and quality of care are forerunning concerns for organizations today, and hospitals need to examine how and when they evaluate that quality of care in order to remain ethical and compliant.
Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC, MSHIM, RHIA , writes that one diagnosis in particular that can take extra effort to understand is acute kidney injury (AKI). Frequently reviewing coding and CDI challenges related to AKI will ensure proper coding and reimbursement.
Sarah Nehring, RHIT, CCS, CCDS, says ICD-10-CM reporting for diabetes can be complex, that’s why it’s important for inpatient coders to regularly review reporting requirements for this diagnosis and associated complications. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Coders and CDI professionals should be active in the rule-making process for the IPPS, as their specific skills and knowledge can make a large impact on what appears in the final rule.
All inpatient coding and CDI professionals, whether new to the field or industry veterans, should be familiar with the American Hospital Association’s Coding Clinic . This article reviews the steps to take and the importance of submitting coding questions.
In this article, Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC, MSHIM, RHIA , breaks down acute respiratory distress syndrome (ARDS) and sepsis criteria and reviews documentation and querying for these diagnoses through a case study.
Due to the drug ivermectin’s uptick in misuse for treating COVID-19, Susan Belley, MEd, RHIA, CPHQ, reviews ICD-10-CM reporting for poisonings, adverse and toxic effects, and underdosing. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Sarah Nehring, RHIT, CCS, CCDS , shares insight on the clinical concepts behind new fiscal year 2022 ICD-10-CM code I5A (non-ischemic [non-traumatic] myocardial injury) and Coding Clinic, Third Quarter 2021, advice regarding myocardial infarctions due to in-stent stenosis. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In this article, Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC, MSHIM, RHIA , breaks down the various definitions and criteria for sepsis and reviews documentation and querying for this diagnosis through a case study.