Ethical dilemmas can creep in at any time during a coder’s average workday. However, one might be hard pressed to find a coder who will openly acknowledge this. Brad Hart, MBA, MS, CMPE, CPC, COBGC, and Kathy DeVault, RHIA, CCS, CCS-P, explore how coders can and should handle ethical dilemmas.
Although hospital infection rates continue to decline, Medicare payment penalties are not the cause, according to the New England Journal of Medicine article titled Effect of Nonpayment for Preventable Infections in U.S. Hospitals .
In ICD-9-CM, coders report specific codes to indicate a surgeon used robotic assistance. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, explains how that will change in ICD-10-PCS.
CMS has published two ICD-10-related Special Edition Medlearn Matters articles that may be of interest to providers and serve as tools to assist with implementation.
Assess. Educate/train. Practice. Gloryanne Bryant, RHIA, CCS, CDIP, CCDS, and Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P CDIP, reveal how following those three steps can prepare you for ICD-10 implementation.
ICD-10-CM code category J45.- includes new, more specific terms for asthma that may help improve data quality and lead to more effective research and treatments. Deborah Grider, CPC, CPC-I, CPC-H, CPC-P, CPMA, CEMC, CPCD, COBGC, CCS-P CDIP, and Suzan Berman, CPC, CEMC, CEDC, detail the new terminology for asthma coding in ICD-10-CM.
Q: I have a question about coding transplant complications. My understanding is if the complication affects the transplanted organ, then coders should assign a code for the transplant complication itself. Is this correct? Consider the following physician documentation: Final A/P: Acute renal failure in patient with history of renal transplant. Should coders report 996.81 (complications of transplanted kidney) and 584.9 (acute kidney failure, unspecified)? Also consider this documentation: CHF in heart transplant patient . Should coders report 996.83 (complications of transplanted heart) and 428.0 (CHF, unspecified)?
The OIG estimates that Medicare Administrative Contractors paid $8.4 million in overpayments to inpatient rehabilitation facilities (IRFs) because IRF and Medicare payment controls did not adequately identify late submissions of patient assessment instruments.
Provider documentation of inpatient wound care services may be confusing at best and completely lacking at worst. Coders end up trying to decipher exactly what procedure the provider performed. Gloryanne Bryant, BS, RHIA, RHIT, CCS, CDIP, CCDS, and Robert S. Gold, MD, offer tips to assist coders in choosing the correct code for inpatient wound care.
The HIM profession is constantly changing, but HIM professionals are still responsible for maintaining the integrity of the health records. Lou Ann Wiedemann, MS, RHIA, FAHIMA, CPEHR, explains why HIM professionals can—and should—also play a role in clinical documentation improvement (CDI).
Inpatient-only procedures are those that CMS has determined providers must perform on an inpatient basis. Kimberly Anderwood Hoy, JD, CPC, and Beverly Cunningham, MS, RN, unravel the complexities of coding for these procedures.
Patients aren’t the only ones paying attention to quality scores these days. Payers are, too. Cheryl Manchenton, RN, BSN, and Audrey G. Howard, RHIA, explain why coders and clinical documentation improvement specialists must understand which conditions affect provider profiles.
Coders are the backbone of an organization’s fiscal health. Timely coding leads to timely revenue collection. Glenn Krauss, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, discusses why coders must be willing to look beyond their traditional roles to help ensure the continued financial viability and success of the organization.
Coders play a crucial role in ensuring compliance, and the FY 2013 IPPS final rule , released August 1, gives them many reasons to showcase their skills. William E. Haik, MD, FCCP, CDIP, and Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS, detail the changes and how coders can take charge of them.
Providers may find themselves with a completely new definition of the term inpatient if CMS follows through with its intent to clarify this ever-confusing patient status, as explained in the 2013 OPPS proposed rule published July 30. The agency solicits input from providers on pp. 45155-45157 of the rule and suggests that it may implement fairly significant changes going forward.
Do you audit records before sending them to your Recovery Auditor? If not, your hospital may be one of many that simply doesn't have the resources to do so. Lori Brocato, Cathie Eikermann, MSN, RN, CNL, CHC, and Laura Legg, RHIT, CCS, reveal why hospitals should consider auditing records before sending them to the Recovery Auditor.
Providers are urging CMS to reconsider its current ICD-10 education and outreach strategy to ensure that providers are prepared to implement the new code set. CMS published and addressed specific provider comments in a final rule released August 25 that confirms the delay of ICD-10 to October 1, 2014.
Program for Evaluating Payment Patterns Electronic Report compares hospital data regarding a variety of benchmarks. John Zelem, MD, FACS, and Brenda Hogan, RN, BS, explain how hospitals can use PEPPER to identify risk areas and create a plan for self-auditing.
