HCPro.com: Briefings on Coding Compliance Strategies

Submitting improper Medicare documentaion can lead to denial of fees, payback, fines, and increased diligence from payers. Let BOCCS help you avoid fraud and stay in compliance.

To view the entire newsletter issue, click the “View Entire Issue” link below

October 2008 (Volume 11, Issue 10)	view entire issue

Prepare for the arrival of the new ICD-9-CM codes
Now that fall is here, coders need to be ready to use the new and revised ICD-9-CM codes. The following is a rundown of some of the important changes to the index and tabular sections of the 2009 ICD-9-CM Manual.

Get to know MIPPA’s hospital-related provisions
On July 15, Congress enacted the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The timeline for MIPPA is as follows: Passed by House of Representatives: June 24 Passed by Senate: July 9 Vetoed by President George W. Bush: July 15 Veto overridden: July 15 Effective date: Varies by provision

Avoid the trap of probable diagnoses
Most inpatient coders are accustomed to seeing “probable,” “suspected,” “likely,” “questionable,” “possible,” “still to be ruled out,” or other similar terms in physician progress notes indicating uncertainty in physicians’ diagnoses. But if coders code these uncertain diagnoses without physicians bringing them forward in their final notes or discharge summaries, there could be trouble with recovery audit contractors (RAC) or other outside auditors.

Guidelines explain new codes for pressure ulcer staging, VAP
One of the more challenging series of new ICD-9-CM codes assists in fully describing pressure ulcers by indicating ulcer staging (707.20–707.25).

Look forward to improved complications data
In the beginning, there was raw data: one hospital’s death rate compared to another hospital’s death rate. Obviously, the hospital with the higher death rate didn’t deliver medical care as well as the hospital with the lower death rate. Statisticians compared hospitals’ average cost per patient, raw complication rate, or length of stay data.

Other recently-published articles from Briefings on Coding Compliance Strategies:

New guidance may create additional query opportunities

MS-DRGs on OIG radar: Ensure compliant coding

CMS discusses RAC expansion, ICD-10, and never events

CMS issues updated payment rates and wage indexes for FY 2009: Know how to apply the new data files

Go back to the source when coding secondary diabetes

Work with physicians to obtain clear-cut documentation for pressure ulcers

Get a bloody good understanding of GI hemorrhage

Clear up morphology and neoplasm code confusion

Brush up on the 2009 ICD-9-CM carcinoid codes

Examine postoperative condition coding

One-day stays

Look forward to improved complications data

Guidelines explain new codes for pressure ulcer staging, VAP

Avoid the trap of probable diagnoses

Get to know MIPPA’s hospital-related provisions

ABOUT HCPRO

PRESS

CAREERS @ HCPRO

ADVERTISING OPPORTUNITIES

ONLINE STORE

200 HOODS LANE

P.O. BOX 1168

MARBLEHEAD, MA 01945, USA

PHONE: 800/650-6787

FAX: 781/639-7857

Copyright Statement	Privacy Policy

*MAGNET™, MAGNET RECOGNITION PROGRAM®, and ANCC MAGNET RECOGNITION® are trademarks of the American Nurses Credentialing Center (ANCC). The products and services of HCPro, Inc. and The Greeley Company are neither sponsored nor endorsed by the ANCC