HCPro.com: Medical Records Briefing

Guiding Health Information Management professionals through the continuously changing field of medical records and toward a stronger process for fifteen years!

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June 2008 (Volume 23, Issue 6)	view entire issue

Recovery audit contractors: Learn from your peers
Editor's note: This is the first in a two-part series in which HIM directors in three RAC states recount their experiences with audits thus far. This article will discuss staffing, forming a RAC team, and productivity. Next month's focus will be on appealing denials and tracking data. As your HIM department prepares for the national expansion of the Recovery Audit Contractor (RAC) program in 2010, there is no better source of advice than hospitals in states where RACs are already present. HIM directors from California, New York, and Florida shared their implementation perspectives at a roundtable discussion during HCPro's March 11 audioconference, "Recovery Audit Contractors: Lessons Learned to Help Your Hospital Prepare Now."

Callers continue to ask questions about RAC preparations
If you have questions pertaining to recovery audit contractors (RAC), you're not alone. HCPro received a flood of e-mails from callers who participated in its March 11 audioconference, "Recovery Audit Contractors: Lessons Learned to Help Your Hospital Prepare Now." The following is a sample of some of the topics that our speakers addressed.

Coding common summertime ailments: Review guidelines for allergic reactions, sunburns, and more
Instructions: Encourage staff members to review these common coding scenarios that involve summertime ailments. Scenario 1: A patient presents to the emergency room (ER) complaining of severe pain and swelling due to multiple bee stings on one arm. After evaluation, the physician diagnoses the patient with multiple bee stings with allergic reaction. The ER physician prescribes ibuprofen and an antihistamine for treatment of these symptoms. Which of the following diagnosis codes are appropriate?

Don't make a hasty decision when selecting an EHR vendor
A hasty EHR vendor selection can lead to frustration at best or a failed implementation at worst, says Michael R. Cohen, MM, president of MRC Consulting Group in St. Charles, IL. Strategy details will vary depending on the type and size of the buyer, but organizations should follow some general steps when selecting an EHR vendor, Cohen says.

Stage pressure ulcers: specify origin and location so coders can reflect patient severity and assign proper codes
Dear colleagues: The fiscal year 2009 Inpatient Pro-spective Payment System proposed rule released April 14 broadened the hospital core measure quality reporting/reimbursement process to 72 metrics by 2010 and expanded the number of preventable conditions for which reimbursement will be withheld unless they are present on admission (POA). Additionally, 30-day risk-standardized readmission rates for three conditions are proposed as new core measures, requiring physicians and hospitals to collaborate in preventing repeat hospitalizations.

Other recently-published articles from Medical Records Briefing:

Electronic health IT advances create opportunities, challenges for HIM directors and staff members

Requirements for patient discharge and transfer

Put a stop to stamped signatures once and for all

AHIMA’s final query practice brief reflects growing CDI efforts

How to code common winter ailments

Knock, knock! Who’s there? It’s ICD-10, and you’d better be ready

HIPAA: Transcription, breaches, and PHI for research

Ask what leadership means, and use self-assessment to pinpoint strengths and weaknesses

Understand the details of personal health records to serve as a valuable patient resource

Flag identity theft as federal rule takes effect

Polish your profile by clarifying heart failure, pneumonia, and pressure ulcers

Diabetes classification integral to hospital quality measurement, correct code capture

Address coder shortage with an apprentice program

Know requirements for sedation and anesthesia

Ensure that coders review the new ICD-9-CM coding guidelines effective October 1

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