CMS discloses DRG coding vulnerabilities for inpatient hospitals
Recovery Auditor Report, June 30, 2011
In an effort to provide helpful information to providers, CMS released a special edition MedLearn Matters (MLN) article that disseminates DRG coding vulnerabilities for inpatient hospitals.
Recovery auditors review the entire medical record when performing DRG validation reviews, but oftentimes hospitals code the record prematurely, according to Donna Wilson RHIA, CCS, CCDS, senior director at Compliance Concepts, Inc. in Wexford, PA.
“As we know, hospitals code and finalize the claim without the final discharge summary documentation, given the struggles in meeting bill hold deadlines imposed by financial deadlines,” she says. “External auditors—such as the recovery audit contractors (RACs)—have access to the entire medical record, which includes the discharge summary.”
Related Products
-
Core Skills for Hospital Case Managers:
A guide to fundamental case management responsibilities, Core Skills for Hospital Case Managers serves as a training...
-
Combat RAC Denials: Strategies for Successful Appeals
During this 90-minute audio conference, our speakers provide step-by-step procedures, timelines, tools, and best practices...
-
The 2013 Medicare Compliance Forum: Las Vegas, NV
-
Level of Care Determinations for 2014: Las Vegas, NV
Attend the half-day seminar, Outpatient, Observation or Inpatient? Continuing to Walk the Tightrope of Regulatory Guidance...
-
OPPS and IPPS Reimbursement Fundamentals: Las Vegas, NV
Attend OPPS and IPPS Reimbursement Fundamentals, a half-day seminar on October 2nd in Las Vegas. Learn how CMS’ substantial...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Q&A: Primary, principal, and secondary diagnoses
- OB services: Coding inside and outside of the package
- Practice the six rights of medication administration
- ICD-10-CM coma, stroke codes require more specific documentation
- Understanding and coding for critical care services
- Complications from immobility by body system
- Neurological checks for head injuries
- Understand and overcome language, cultural barriers
- E-mailed
-
- Worker wellness: Stress reduction and mental health
- Utilizing restorative nursing in your SNF
- Study: Patients equally satisfied with virtual encounters compared to in-person visits
- Sedation privileges for ED physicians
- Q&A: How should we code fluoroscopy for outpatient procedures?
- Nursing responsibilities for managing pain
- Note similarities and differences between HCPCS, CPT® codes
- Know the medical gas cylinder storage requirements
- How to Create an N95 Mask Disinfection Facility for Less Than $15,000
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Searched
