Keeping up with changing coding guidance adds to the complexity of reporting digestive procedures. In this article, Adrienne Commeree, CPC, CPMA, CCS, CEMC, CPIP , reviews ICD-10-PCS reporting for common digestive procedures including the Whipple procedure and lysis of adhesions. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Kay Piper, RHIA, CDIP, CCS, details the process of submitting ICD-10-CM codes to the ICD-10 Coordination and Maintenance Committee meeting by sharing the experience a medical coding educator and a CDI physician adviser had when submitting a proposal for the March 2018 meeting.
Karen, a 67-year-old patient with a history of hypertension, diabetes, and tobacco use, presents to her primary care physician with complaints of pain in her right buttock and thigh when she walks from her house to her mailbox. She is then admitted as an inpatient for surgery.
Cheryl Manchenton, RN, explains CMS’ Hospital-Acquired Condition Reduction Program (HACRP) and says inpatient coding professionals can play a significant role in HACRP success by understanding the basis for hospital-acquired condition scores and ensuring that documentation and coding accurately and fully captures patient conditions and complications.
A transcatheter aortic valve replacement (TAVR) is an interventional cardiology procedure that has proven to be an important life-saving cardiac intervention frequently seen by inpatient coders. In this article, Stephen Houlahan, RN, MSN, MBA, CCDS, reviews TAVR history, clinical background, and documentation and reimbursement methodologies to ensure proper education and compliance for facilities.
Coders often wonder how to define realistic productivity benchmarks. Different facilities establish the responsibilities and expectations of their coding teams, so productivity standards are not uniform.Coders often wonder how to define realistic productivity benchmarks. Different facilities establish the responsibilities and expectations of their coding teams, so productivity standards are not uniform.
Trey La Charité, MD, FACP, SFHM, CCS, CCDS, reviews the clinical validation of acute congestive heart failure (CHF) exacerbation and shares his hospital’s coding and documentation strategy to help in appeal battles.
With March declared National Endometriosis Awareness Month, Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, HCS-D, details endometriosis-related procedure reporting for inpatient coders. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Adriane Martin, DO, FACOS, CCDS, details the updates found in the 2019 ACDIS/AHIMA “Guidelines for Achieving a Compliant Query Practice” and writes that thorough knowledge of query guidelines is essential for inpatient coders and staying abreast of these guideline updates is crucial.
Not many clinical conditions cause more consternation for inpatient coders and CDI specialists than acute and chronic respiratory failure. In this article, William E. Haik, MD, FCCP, CDIP, details acute and chronic respiratory failure and the critical elements in the health record that validate their reporting.
Laurie L. Prescott, MSN, RN, CCDS, CDIP , details the basics of ICD-10-CM/PCS for newer inpatient coders including a review of the ICD-10-CM seventh-character extension, placeholder use, and ICD-10-PCS root operations. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
The benefits outweigh the difficulties when it comes to retrospective reviews. How do you get started with this new venture? Like many aspects of CDI, there are many ways to approach the problem. This article details these approaches, including how to enhance coder and CDI collaboration for these reviews.
If we look at each element of a coding audit, we can see the benefits these coding reviews provide. Every healthcare organization and hospital should invest in routine, internal coding audits. The alternative is waiting until the payer conducts an audit, denies a claim, and incurs costs for the organization.
As an inherited blood disorder, sickle cell disease is passed from parent to child. Children with sickle cell disease often have two defective hemoglobin S genes , one from each parent. However, various forms of sickle cell disorder also occur when a person inherits one hemoglobin S gene (sickle cell gene) from one parent and a different type (other than the S type) of defective hemoglobin gene from the other parent. All of these forms have distinct ICD-10-CM diagnosis codes, making reporting complex.
Consider the story of a patient—say, a pneumonia patient—whose treatment cost a lot of money. The hospital’s reimbursement for that care, however, was less than the cost of providing it. Now say someone looked at that case and how complex it was, and then saw that the reimbursement only paid for half the cost of caring for that patient. That’s how CDI was born.
In 2013 the “ Guidelines for Achieving a Compliant Query Practice ,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. Since that time this brief has been updated twice: once in 2016 and most recently in 2019 .