Coding Clinic , Second Quarter 2017, which became effective May 17, did not disappoint in addressing clinical issues affecting us in coding compliance and instructing us in how to properly use the ICD-10-CM Index and Table. Let’s review several of Coding Clinic’s changes.
Many national organizations, such as the Centers for Disease Control, the American Liver Foundation, the Department of Health and Human Services, and the Food and Drug Administration have information and resources available to provide education and promote testing for viral hepatitis.
When someone decides to enter the world of medical coding, they usually start off coding for obstetric and newborn charts. After coding for a month or two, the newbie coder is transitioned to low-dollar queues; usually encompassing charts $10,000 and less. Gradually, he or she works toward the medium-dollar and moderate-procedure queues between $20,000-$39,000.
Turning the microscope to critically examine the program you painstakingly created is no easy task. It is a challenging process that requires a fair amount of humility and humbleness. It’s hard to accept that your program, your staff, and you (the physician advisor) might suddenly not be as effective as you previously believed. Believe me, I speak from experience.
Most healthcare systems already have a proven process in place to monitor revenue integrity and ensure correct reimbursement. Beyond the day-to-day revenue cycle staff involved in revenue integrity, more than 60% of hospital executives believe revenue integrity is essential to their organization’s financial stability and sustainability, according to a survey by Craneware, Inc .
A recent Coding Clinic has garnered a lot of questions on inpatient obstetrics coding. While coders were originally taught to use multiple codes for the repair of a third- or fourth-degree perineal laceration, Coding Clinic , First Quarter 2016, states that you don’t use multiple codes for third- and fourth-degree tears, because you need to code to the “deepest layer.”
While you thought that we’ve finally mastered coding compliance with DRGs and quality measures, now it is time to learn the compliance risks and opportunities with a new risk-adjustment method applicable to MACRA, Hierarchical Condition Categories (HCC).
Alcohol, as a legal substance for those 21 and older, is commonly seen as more benign than illicit drugs such as heroin and cocaine. However, alcohol can also physically harm the body in many ways. In ICD-10-CM, the categories related to alcohol fall under category F10.- (alcohol-related disorders).
All of us in ICD-10-CM/PCS coding compliance are facing a tsunami of denials from payers, Recovery Auditors, and Medicare quality improvement organizations. This is due to the auditors’ removal of ICD-10-CM codes based on provider documentation; auditors can perceive that a patient did not have clinical indicators supporting the presence of the documented condition.