Corporate Compliance

Leveraging Clinical Documentation Improvement Throughout the Revenue Cycle

Medicare Insider, August 4, 2015

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Join us October 26 in Charleston, South Carolina, at the 2015 Medicare Compliance Forum Revenue Integrity pre-conference. The morning session, Leveraging Clinical Documentation Improvement Throughout the Revenue Cycle, by Cheryl Ericson, MS, RN, CCDS, CDIP, AHIMA-Approved ICD-10-CM/PCS Trainer, will explain to participants the many ways coded data can affect the revenue cycle. The session will begin with an overview of traditional Clinical Documentation Improvement efforts focusing on direct revenue through the inpatient prospective payment system (IPPS) with an emphasis on the importance of accurate principal diagnosis assignment. The elements used to determine reimbursement under MS-DRGs will be explained as well as the significance of assigning a "working" MS-DRG to anticipate potential reimbursement issues. Participants are then introduced to the expanding roles of Clinical Documentation Improvement as clinical validators to minimize denial vulnerabilities (i.e., ensuring the documentation supports medical necessity as defined by CMS in both the inpatient setting and the outpatient setting, such as NCDs).


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