Consider the story of a patient—say, a pneumonia patient—whose treatment cost a lot of money. The hospital’s reimbursement for that care, however, was less than the cost of providing it. Now say someone looked at that case and how complex it was, and then saw that the reimbursement only paid for half the cost of caring for that patient. That’s how CDI was born.
As an inherited blood disorder, sickle cell disease is passed from parent to child. Children with sickle cell disease often have two defective hemoglobin S genes , one from each parent. However, various forms of sickle cell disorder also occur when a person inherits one hemoglobin S gene (sickle cell gene) from one parent and a different type (other than the S type) of defective hemoglobin gene from the other parent. All of these forms have distinct ICD-10-CM diagnosis codes, making reporting complex.
In 2013 the “ Guidelines for Achieving a Compliant Query Practice ,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. Since that time this brief has been updated twice: once in 2016 and most recently in 2019 .
Joe Rivet, JD, CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, explains that reporting sepsis has long been a challenge for many coders even with the continual release of Coding Clinics and guideline revisions. In this article, Rivet reviews common coding traps for this condition including reporting urosepsis, severe sepsis, and sepsis on admission.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, reviews ICD-10-CM/PCS cardiac coding for American Heart Month and writes that since accurate coding improves data quality for these conditions, which in turn is used for statistics and tracking trends, ensuring the disease process is captured correctly is imperative. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CDI professionals can improve documentation and data scores via a mortality review process. This article discusses the various types of mortality reviews and publicly reported data and gives tips on how to implement a successful mortality review process.
Denise Wilson, RN, MS, RRT, and Karla Hiravi, RN, BSN, explore why coding and clinical denials for acute kidney injury (AKI) and acute tubular necrosis (ATN) are different and the importance of different appeal strategies.
Julian Everett, BSN, RN, CDIP, details her experience reviewing pediatric mortality cases for the first time and gives tips on how the different revenue cycle departments can work together to improve their processes and outcomes.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, HCS-D, reviews Coding Clinic , Fourth Quarter 2018, advice surrounding body mass index reporting and how new advice conflicts with previous guidance. McCall also reviews payment methodologies and the official guideline updates for this condition. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Training new inpatient coders and CDI staff is a big job that often takes several months to conclude, but the end of orientation doesn’t mean that staff members never have to undergo education ever again. As most are keenly aware, the ground is always moving under our feet. From new regulations, to coding guideline changes, to new clinical definitions, education never truly ends.
Alzheimer’s disease is the most common form of dementia, with symptoms that include problems with memory, thinking, and behavior. Understanding Alzheimer’s disease and its symptoms is important to coders, as some of the entries in the ICD-10-CM Alphabetic Index can be confusing.
In 2018, most organizations held the line on coder productivity, according to the results of sister publication HIM Briefings’ 2018 coding productivity survey.
Rules governing code assignment often don’t make sense to those coming from the clinical side, such as CDI. In truth, they often confound professionals with years of inpatient coding experience, too. And most CDI and coding professionals have a list of frustrations when it comes to translating clinical documentation into ICD-10 codes.
The mechanics of the concurrent coding process can cause headaches for both CDI and coding professionals. Plus, one could argue that CDI’s presence itself limits the number of necessary post-discharge clarifications without the process of concurrent inpatient coding. This article reviews ways that CDI programs can get involved with this process and work collaboratively with coders.
Adriane Martin, DO, FACOS, CCDS, reviews Coding Clinic’s Third and Fourth Quarter 2018 advice including reporting for coronary artery bypass grafting, drainage of an abscess in the submandibular space, and diabetes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
This article reviews HCPro’s 2018 coding productivity survey and reviews data on factors that have affected coder productivity, remote coders, and collaboration between coders and CDI specialists, including charts coded per hour and coding accuracy standards.
Assigning the appropriate ICD-10-PCS code for spinal procedures can be a challenge for inpatient coders as they need to correctly identify each character of the seven-character code. In this article, Nena Scott, MSEd, RHIA, CCS, CCS-P, CCDS , offers coding tips for reporting spinal surgery cases in ICD-10-PCS and examines the correct use of each character. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
