Corporate Compliance

Increased focus on quality calls for more queries

Strategies for Health Care Compliance, January 1, 2009

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When it comes to reviewing documentation, the old saying about assuming applies to coders.

For example, a physician documents a condition during the postoperative period. That doesn’t mean coders should code this condition as a postoperative complication. Doing so could adversely affect the hospital’s or physician’s quality scores.

With the increased focus on quality, it is important to report accurate postoperative complications, understand hospital-acquired conditions, and be as accurate as possible when reporting coded data that affect the quality of care a patient received.

In addition, incorrect coding of a postoperative complication could result in a complication and comorbidity (CC) for which the hospital would receive higher payment, which is a potential compliance problem.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Strategies for Health Care Compliance.

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