Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, reviews how critical thinking is important within the CDI and coding realm in order to enhance review accuracy and query rates and to help loosen reliance on technological tools such as encoders.
Alba Kuqi, MD, CICA, CCS, CDIP, CCDS, CRCR, CSMC, MSHIM, RHIA, writes that CDI professionals and inpatient coders need to pay attention to the definitions and clinical indicators of acute kidney injury (AKI) to ensure proper ICD-10-CM reporting and reimbursement.
Through examples given within the wound care setting, Bobbie Starkey, RHIT, CCS-P , shows the importance of documentation and ICD-10-CM reporting to support hierarchical condition category (HCC) capture within the inpatient coding sphere. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Dawn Valdez, RN, LNC, CDIP, CCDS, says that the clinical indicators used to validate sepsis can also have other possible etiologies that could be equally responsible for the clinical indicators that are present—these are known as competing diagnoses.
The Office of Inspector General (OIG) recently released its fiscal year (FY) 2020 Healthcare Fraud and Abuse Control Program report. During FY 2020, the federal government won or negotiated more than $1.8 billion in healthcare fraud judgments and settlements, according to the report.
Sarah Nehring, RHIT, CCS, CCDS, writes that ICD-10-CM/PCS reporting for the cardiac system is complex and requires frequent review in order to report the most accurate codes. In this article, Nehring covers ICD-10-CM/PCS coding and clinical indicators for cardiogenic shock, intra-aortic balloon pumps, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: We recently had a patient admitted with severe acute meningitis causing respiratory decompensation. A diagnostic lumbar puncture and mechanical ventilation were both performed during the inpatient stay. Which of these two procedures would be the principal procedure?
Howard Rodenberg, MD, MPH, CCDS, and Lynn Shay, CPHQ , say that making sense of varying COVID-19 case-mix index metrics is an important endeavor that will sometimes require a bit of DIY. In this article, they explain how they were able to unscramble their departments’ COVID-19 case-mix index data.
CMS released the fiscal year (FY) 2022 IPPS final rule on Monday, August 2, which finalizes its efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. Along with payment rate updates, the final rule also repealed the MS-DRG relative weight methodology and hospital cost-reporting requirement finalized in the 2021 IPPS final rule.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, writes that inpatient coding for pacemaker Insertions can be confusing to both novice and experienced coders. Because of this, it’s important for all inpatient coders to regularly review ICD-10-PCS reporting for these procedures. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Trey La Charité, MD, FACP, SFHM, CCS, CCDS, writes that organizations that aren’t reviewing all in-hospital mortality cases are missing some tremendous opportunities to improve reimbursement and documentation.
The fiscal year (FY) 2022 ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting, both effective October 1, were recently released by the Centers for Disease Control and Prevention and CMS, respectively.
A recent study highlighted growing evidence that patients of all ages can develop type 1 diabetes after an acute COVID-19 infection. In this article, Susan Belley, RHIA, CPHQ, and Audrey Howard, RHIA, evaluate these findings as well as ICD-10-CM reporting for the two conditions.
Sarah Nehring, RHIT, CCS, CCDS , reviews ICD-10-CM reporting and clinical criteria for various types of heart failure including diastolic, systolic, hypertensive, and more. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Q: Would telemetry and the continuation of home medications be considered continued care for a myocardial infarction (MI) or treatment when reporting in ICD-10-CM? Would this meet the definition of a secondary diagnosis?