Health Information Management

PPV: Avoid inappropriate physician queries

HIM Connection, September 16, 2008

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Since the implementation of Medicare Severity DRGs in October 2007, the volume of physician queries has undoubtedly increased. Many of these queries are warranted and consistent with the aims of greater specificity and accurate reporting of patient severity.

However, some situations show few clinical indications for querying the physician other than the coder’s knowledge that additional specificity is necessary, says Paula Archer, RHIA, managing consultant at BKD, LLP, in Little Rock, AK.

Editor’s note: For more information on inappropriate queries and to purchase a copy of this article for $10, click here. Subscribers to Briefings on Coding Compliance Strategies can read this article in the September issue.



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