Health Information Management

Determine effect of MS-DRG changes in 2010 IPPS final rule

Briefings on Coding Compliance Strategies, November 1, 2009

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So why are five of the top 21 relative weight increases wound debridement procedures? Gold said no one is reporting debridement as frequently due to concerns regarding Recovery Audit Contractor (RAC) audits.

“People are afraid of assigning the code because of [the risk of] inappropriate assignment,” Gold said. “It is seen as an overcoded procedure.”

Gold suggested evaluating cases at your facility with code 86.22, excisional debridement of wound, infection, or burn.

Focus on the physician’s documentation—the fact that it says “excisional debridement” in the documentation isn’t enough, Gold said.

“We have to understand what the goal was for assigning the code for debridement of the skin. The intent should be met in the physician’s documentation,” he said. “The fact that the physician says excisional debridement in the report doesn’t prove excisional debridement—that’s where you get into trouble, and that’s where you can be accused of overcoding.”

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