Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRD, CCDS, writes that while the fiscal year (FY) 2019 IPPS proposed rule is considering the downgrade of ICD-10-CM code B20 (human immunodeficiency virus [HIV] disease) from an MCC to a CC, it does not mean that diagnosing and coding for HIV has lessened in complexity.
It is well known that ICD-10-CM/PCS code assignment impacts hospital reimbursement and compliance; however, there is an additional code that often flies under the radar for inpatient coders—the discharge status code. Inaccurate discharge status code assignment for Medicare post-acute care transfers (PACT) can lead to under reimbursement and compliance risks for hospitals.
The thyroid gland, included in the endocrine system, is a small gland located at the base of the neck. Although small when compared to the other components of the endocrine system, the thyroid gland plays a significant role in overall body function, influencing the performance of the heart, brain, liver, kidneys, and skin.
Allen Frady, RN-BSN, CCDS, CCS, CRC, writes about guidance related to documenting acute respiratory insufficiency and gives tips to coders and CDI teams on what to do when the conditions are over-documented postoperatively.
A diagnosis of autism spectrum disorder (ASD) now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified, and Asperger’s syndrome. Peggy Blue, MPH, CCS, CCS-P, CPC, CEMC , reviews these terms to aid accurate coding. 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, writes that the various approaches hospital systems use to optimize their DRG-based case-mix index or HCC-based risk adjustment factor scores will likely conflict with how an accountability agent will see those measurements.
I was recently reviewing Coding Clinic , First Quarter 2018, and felt that the question regarding physeal fractures needed more clarification and explanation than was provided in the official answer.
Coders often seek definitions for realistic productivity benchmarks, and standards depend on how a given facility establishes the responsibilities and expectations of its team. Therefore, before assessing a coder’s success, a facility must set goals that define that success. 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, CCDS, CDIP, writes that 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. In this article, he reviews several pitfalls that could await facilities.
Danielle Richmond says that while inpatient coder shortages are nowhere near what they were with ICD-9-CM, new challenges have emerged. This article shares important advice for any managers trying to improve their coder recruitment and hiring process.
Yvette M. DeVay, MHA, CPC, CPMA, CIC, CPC-I , reviews the anatomy of the brain and details treatments and surgeries associated with the brain and how to report them in ICD-10-CM/PCS.
Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, writes that even though CDI specialists are not coders, it’s important to learn the rules and guidelines that coders follow. CDI teams need to reference guidance and guidelines in their daily work to ensure documentation is clear, concise, and supportive of accurate code assignment true to the patient’s story.
Laura Legg RHIT, CCS, CDIP, looks at the results of Central Learning’s second annual ICD-10 Coding Contest and highlights ways facilities can use the data to improve coding performance and accuracy. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
In 2015, I wrote 44 appeal letters challenging DRG validation/coding denials. In 2016, I wrote 88 appeal letters. Last year, I penned 159. We already received more than 40 DRG validation denials in January of this year. Does this trend sound familiar?
The implementation of an EHR is a multifaceted, comprehensive project for healthcare organizations. Though it affects every department and function in some way, the impact on medical record coding may be the most profound and complicated, with some organizations reporting a 20% decrease in coding productivity after EHR implementation.
Traditionally, the Office of Inspector General (OIG) Work Plan is released annually with focus areas identified for the upcoming year. However, as of June 2017, the decision was made to update the plan on a monthly basis to promote transparency by demonstrating a continuous effort to ensure compliance.
The fiscal year (FY) 2018 ICD-10-CM changes have now been active for several months. Though the volume of new codes is relatively small compared to previous updates, the impact on reimbursement has the potential to be quite large.
