Allen Frady, RN-BSN, CCDS, CCS, CRC, reviews various guidance related to clinical validation to help coders and CDI teams better navigate the complex topic.
CMS released the fiscal year (FY) 2019 IPPS proposed rule on Tuesday, April 24, with significant reductions to reporting requirements for quality initiatives and expected ICD-10-CM/PCS code and MS-DRG updates.
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.
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.
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.
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.
Q: We have gotten conflicting advice regarding ICD-10-CM code categories B95-B97 (Bacterial and viral infectious agents) regarding CCs, MCCs, and severity of illness/risk of mortality. Could you clarify the impact of reporting causative organisms?
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.
Systemic inflammatory response syndrome (SIRS) criteria has a greater sensitivity than quick sepsis-related organ failure assessment (qSOFA) as a screening test to initiate treatment for sepsis in non-intensive care unit patients, according to the recent study published in the Annals of Internal Medicine.
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.
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.
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.
Q: We are having trouble determining what qualifies a patient as having an acute myocardial infarction (MI) and what documentation would support the diagnosis. Can you help our coding team clarify?
Of emergency department visits attributable to ruptured abdominal aortic aneurysm, acute myocardial infarction, stroke, aortic dissection, and subarachnoid hemorrhage, the conditions were not accurately diagnosed approximately one out of 20 times, according to a study by the Journal of the American Medical Association (JAMA) .
Paul Evans, RHIA, CCDS, CCS, CCS-P, tackles the various characteristics of creating a query and says that while all portions of any program, such as education and metrics, are important, the proper formulation of a query represents the most important task for a CDI professional.
An Office of Inspector General (OIG) audit of the University of Michigan Health System revealed noncompliance with four types of inpatient claims, including those associated with the billing of high-severity-level MS-DRGs.
James S. Kennedy, MD, CCS, CDIP, CCDS , reviews readmission rates and writes that if physicians learn the foundations of readmission measurement and implement some basic principles and workflows for reporting clinically accurate ICD-10-CM/PCS coding, hospitals can succeed with readmission measures.
Osteoarthritis is the most common joint disorder in the United States and one of the leading causes of chronic pain and disability, according to the National Institutes of Health. In this article, Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, examines ICD-10-CM/PCS coding and associated guidance for this condition. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
