Q: When coding and trying to sequence a diagnosis such as pneumonia and chronic obstructive pulmonary disease, I understand that there is a “use after” mandate, but how are coders to know which codes the “use additional code” note is providing sequencing advice for?
On October 31, CMS announced that it awarded contracts to the next round of Medicare fee-for-service Recovery Auditors. The base period for contracts is 12 months from the date the contract is awarded, said CMS.
MS-DRG audits are nothing new, but their frequency has significantly increased over the last two years. In this article, Sam Antonios, MD, FACP, FHM, CPE, CCDS , gives facilities tips to increase the likelihood of overturning MS-DRG denials.
Laura Legg, RHIT, CCS, CDIP, AHIMA-approved ICD-10-CM/PCS trainer, writes that coders need to review the newly released coding guidelines in detail in order to understand the changes and implications the new standard for clinical validation has on their facilities.
CMS released the 2017 OPPS final rule November 1, implementing site-neutral payment policies required by Section 603 of the Bipartisan Budget Act, adding new comprehensive APCs, and refining several packaging policies.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, continues her look at 2017 diagnosis code changes for genitourinary conditions by focusing tips for reporting urinary and male genitourinary diagnoses.
Providers frequently need to treat fractures in the ED, so coders need to be aware of the types of fractures and how to report them using CPT codes. Review types of fractures, treatment, and coding tips for reporting fractures in the ED.
Providers need to make sure that electronic order templates include all the necessary information to bill correctly and avoid issues during audits. Valerie A. Rinkle, MPA, writes about what must be contained in the order and ICD-10-specific updates providers should consider.
According to the recent RACTrac survey released from the American Hospital Association, 60% of claims reviewed by Recovery Auditors in the second quarter of 2016 were found to not have an overpayment.
Providers are still working to understand the impact of the February release of the controversial third international consensus definitions for sepsis and septic shock. James S. Kennedy, MD, CCS, CDIP , tackles this new sepsis definition in part two of his two-part series.
Erica E. Remer, MD, FACEP, CCDS, writes about how using unspecified diagnoses in the inpatient world results in deflated quality metrics. Remer helps clinical documentation specialists remedy the situation and gives advices on how to aid providers in documenting to the level of specificity that is now needed.
Shannon Newell, RHIA, CCS, discusses a refined version of the Patient Safety Indicator (PSI) 90 composite by the Agency for Healthcare Research and Quality, and how it has a significant impact on what discharges are included in PSI 15. Note: To access this free article, make sure you first register for the free content if you do not have a paid subscription.
Q: If a patient is extubated post-operatively, but continues to be treated with supplemental oxygen, when is a query for acute respiratory failure appropriate?
This article is part two of a two-part series on the definition changes for sepsis. Reread part one in the October issue of BCCS. In my October Clinically Speaking column, we discussed the evolution of the definition of sepsis and its implications in clinical care (Sepsis-1, Sepsis-2, and Sepsis-3), quality measurement (CMS' SEP-1 core measure), and ICD-10-CM coding compliance.
The recent adoption of a refined version of the Patient Safety Indicator (PSI) 90 composite by the Agency forHealthcare Research and Quality (AHRQ) has a significant impact on what discharges are included in PSI 15 (Unrecognized Abdominopelvic Accidental Puncture Laceration Rate).
The new guideline for code assignment and clinical criteria in the 2017 ICD-10-CM Official Guidelines for Coding and Reporting does not mean clinical documentation improvement is going away; instead it just upped the ante for continued improvement.
Just like the lyrics to the popular Gap Band song say, "You dropped a bomb on me… I won't forget it," there are definitely some changes in the 2017 ICD-10-CM Official Guidelines for Coding and Reporting that some of us may wish the Cooperating Parties will forget were ever mentioned.
Orders for services are a vital component of ensuring Medicare coverage. With the advent of computerized provider order entry (CPOE), it is important to review order templates in the electronic medical record (EMR) and the resulting order produced or printed in the formal legal medical record to ensure the templates meet requirements.