Below is a complete listing of all Management articles that have appeared in JustCoding News.
January 17, 2012
Computer-assisted coding (CAC) is a hot topic these days. Many industry experts claim that CAC is the wave of the future—that its accuracy has been proven, and that humans cannot match its productivity. With CAC, elements such as fatigue, stress, and inexperience are no longer factors that can negatively affect code assignment. Many articles and vendors sing its praises. However, is it really all that? Robert S. Gold, MD, and Lori Cushing, RHIT, CCS, discuss some relevant concepts.
January 17, 2012
Times are changing, and, most likely, so are the jobs of your health information management (HIM) staff members. In some cases, there's a sudden addition of responsibilities, such as the implementation of the recovery audit contractor program. In other cases, the increased use of technology triggers a shift. If these changes aren't managed appropriately, you may end up with declines in performance, careless errors, low productivity, or diminished quality. Elizabeth Layman, PhD, RHIA, CCS, FAHIMA, shares her approach to HIM department and job restructuring.
January 17, 2012
The goals of coding should always be ensuring data accuracy and capturing a patient's true clinical picture. Knowing the intent of an ICD-9-CM code is crucial. However, coding guidelines and official coding guidance sometimes conflict with these goals, putting coders between a rock and a hard place. Robert S. Gold, MD, examines cardiomyopathy, a disease that affects the heart muscle, as an example of a diagnosis that is frequently misreported due to inaccurate guidance.
January 3, 2012
Coders should already be familiar with the 285 new, revised, and deleted ICD-9-CM codes that CMS finalized for fiscal year (FY) 2012. However, it’s critical that providers also examine how these changes directly affect MS-DRG assignment. Robert Gold, MD, examines a number of these changes, including MS-DRG assignment related to cardiac-specific comorbidities, autologous bone marrow transplants, excisional debridement, and thoracic aneurysm repair.
January 3, 2012
When Jim Brown, FHFMA, RHIA, CCS, started working at Jefferson Regional Medical Center in early November 2010, he quickly realized that there were a number of opportunities to improve their health information management operations and efficiencies. In this article, Brown shares strategies and tips for how he and his management team were able to identify areas that needed improvement and reduce department expenses and come in 9.5% ($149K) under budget for the end of fiscal year 2011.
January 3, 2012
Medicare Advantage plans rely on the Hierarchical Condition Categories (HCC) system for reimbursement. HCC payments are linked to the individual health risk profiles for the members in the plan. MA Plans use ICD-9-CM codes as the primary indicators of each member’s health status. Therefore, it is essential for MA plans to make sure that providers capture the complete diagnostic profile of patients through accurate and complete physician coding. Holly J. Cassano, CPC, explains why coders need to have a complete understanding of the HCC process and risk adjustment, as well as the effects on the provider, the member, the MA plan, and overall reimbursement.
December 17, 2011
To successfully transition to ICD-10-CM/PCS in 2013, providers and payers are going to need to cooperate and communicate along the way. In the spirit of this notion of maintaining a collaborative partnership, JustCoding asked Patrice DeVoe of Tufts Health Plan and Ellen MacMullin of Winchester Hospital to share their organization’s progress with implementing ICD-10.
December 17, 2011
Although many providers believe that it may be too early for intensive ICD-10-CM/PCS education and training, there seems to be a growing consensus that now is the time to form an education strategy and identify times when coders, clinical documentation improvement staff, and physicians can work together improve documentation specificity. Deborah Beezley, RHIT, and Adelaide M. La Rosa, RN, BSN, CCDS, share tips for conducting assessments, identifying which departments need training, examining the patient population to help focus where to focus training efforts.
December 6, 2011
Coders should not underestimate the vital role they play in their organization’s efforts to be proactive in reducing improper payment allegations from a variety of auditors, who are aiming to reduce healthcare costs through second-guessing of providing coding and billing. Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS, CCDS, uses clinical examples of improper coding that led to RAC-related down-coding and hospital financial recoupments to demonstrate how despite a commitment to coding ethics, unintentional coding practices can contribute to what RACs deem as improper payment.
November 8, 2011
The Medicare and Medicaid electronic health record (EHR) incentive programs are well under way at this point. The federal Medicare incentive program began issuing payments earlier this year, and many states have already done so as well for the Medicaid program. Aside from meeting the meaningful use criteria, at the end of the day, the point of the huge investment and the hassle of implementation is to meet your goals. To this end, Margret Amatayakul, MBA, RHIA, CHPS, CPHIT, CPEHR, CPHIE, FHIMSS, shares several suggestions for providers for meeting these goals.