Clinical validity, documentation, and ICD-10-CM coding applicable to liver disease remains a great challenge to those invested in severity and risk-adjustment coding compliance.
Because Hierarchical Condition Categories (HCC) and similar risk-adjustment methodologies impact physician and hospital practices, James S. Kennedy, MD, CCS, CDIP, CCDS , reviews CMS’ Risk-Adjustment Data Validators (RADV) instructions to improve HCC compliance.
According to the American Cancer Society, in 2017 there were an estimated 1,688,780 new cancer cases diagnosed and 600,920 cancer deaths in the U.S. In this article, Peggy Blue, MPH, CCS, CCS-P, CPC, CEMC , breaks down the usage of the ICD-10-CM neoplasm table and reviews coding for neoplasm admissions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Emergency departments at designated trauma centers encounter some of the most complex patients—and with them, a complicated documentation web that’s difficult to untangle, making trauma case review essential for hospitals.
Outsourced coding audits for ICD-10-CM and ICD-10-PCS code sets are a common practice in inpatient facilities, and from national healthcare systems to physician practices, outside coding experts are engaged to audit coding accuracy, quality, and performance.
In November 2017, HCPro asked healthcare professionals about ICD-10 coding productivity. Based on respondent feedback, respondents were asked to report productivity based on records per hour or records per day. In previous years, respondents were asked to report productivity based only on records per hour.
Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP, writes that since there is such a prevalence for obesity in our nation, it’s a no brainer that correctly assigning and fully understanding the ICD-10-CM/PCS codes for obesity-related conditions is imperative for coders in any facility.
Creating a query and knowing when to query can be complicated, and there are a number of training tactics that can prove successful for coders when trying to improve upon physician query practices. For this article, let’s take a look at when coders should query and when it’s appropriate for them to cite clinical evidence. 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, CCDS, reviews some ICD fundamentals and to help facilities develop a strategy that will ease the transition to the new administrative language as the federal government moves toward deployment of the International Classification of Diseases, 11th Edition, for Mortality and Morbidity Statistics (ICD-11-MMS).
Congestive heart failure (CHF) is a commonly diagnosed condition where the ventricles or the lower chambers of the heart do not work effectively. The heart serves as a pump to get blood in and then out of the heart to circulate to the rest of the body. When any type of pump doesn’t work efficiently, backups can occur.
Surprisingly, thyroid disease is more common than diabetes or heart disease, with an estimated 20 million Americans having some form of the disease. In this article, Yvette M. DeVay, MHA, CPC, CPMA, CIC, CPC-I gives readers a background on thyroid cancer and reviews ICD-10-CM/PCS coding for the disease.
With yearly ICD-10 code and guideline updates to the respiratory system, it’s important for coders to stay abreast of changes to ensure documentation and coding integrity. This article takes a closer look at the ICD-10-CM code updates as well as recent Coding Clinic guidance on the respiratory system. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Lynelle A. Clausen, RN, BSN, writes about the struggles she faces as a CDI specialist when dealing with vague documentation, lack of criteria, and the reporting of malnutrition.
In perusing the United States Department of Health and Human Services Office of Inspector General’s (OIG) Work Plan , there are many clinical issues that we in ICD-10-CM/PCS coding compliance must address.
Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, writes about the Office of the Inspector General’s (OIG) recent audit findings regarding the ICD-9-CM diagnosis code for kwashiorkor, and discusses what coders can do to stay compliant when coding guidance is lacking. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Victoria M. Hernandez, RHIA, CDIP, CCS, CCS-P , AHIMA-approved ICD-10-CM/PCS trainer, and Debi Primeau, RHIA, FAHIMA , highlight several areas that illustrate the increasing importance of code specificity to ensure accurate reporting and appropriate reimbursement.
While a facility’s case–mix index is an important metric to measure, program managers and directors warn that metrics mean different things to different stakeholders and that CDI programs need to work diligently to present their data within the context of a host of other important measures.
Hospitals are seeing a growing number of staff move off-site. Remote inpatient coders are common and might work from home several days a week. The shift is fueled in part by EHRs: As paper records disappear, it’s less necessary to have staff in nonclinical positions on-site. And, for many hospitals, space is at a premium.
