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Issue 12, December 1, 2007 - VIEW THE FULL ISSUE

• Educate clinical staff to improve your hospital's reporting of POA indicators

  The present-on-admission (POA) indicator is part of Medicare's effort to become an active versus a...

• Understand clinical perspective about how atrial fibrillation gets a bum rap as 'cause of death'

  People don't die of atrial fibrillation. Okay, that's not always true. But on paper it appears as...

• Identify aneurysm location, shape, and type to ensure correct coding

  An aneurysm occurs when an artery becomes filled and dilated with blood because of the pressure of...

• Coding Q&A

  Sandy Nicholson, MA, RHIA, CCS-P, CEO of HCRSolutions, LLC, in Locust Grove, GA, answered the four...

Issue 11, November 1, 2007 - VIEW THE FULL ISSUE

• Coordinated staff, documentation play vital roles in POA reporting

  Although many providers are bracing themselves for yet another regulation to satisfy the...

• ICD-9 guidelines revise coding of sepsis, pain management

  The new ICD-9-CM coding guidelines do not contain any major, sweeping changes, but they do include...

• CMS discusses POA reporting deadlines, inpatient orders

  CMS hosted a Hospital Open Door Forum call on September 27 during which it discussed several topics...

• ICD-10 update: Healthcare industry waits for action

  The healthcare community recognizes the benefits of the ICD-10-CM coding system and is ready to...

• Severity counts despite MS-DRG inadequacies

  I must start with an apology regarding my last diatribe about the newly effective Medicare Severity...

• BCCS Q&A

  BCCS Q&A

Issue 10, October 1, 2007 - VIEW THE FULL ISSUE

• Tips to help tackle MS-DRG challenges, new CC system

  The change to the Medicare Severity DRG (MS-DRG) system brings with it a host of challenges-the...

• CMS Hospital Open Door Forum update

  CMS hosted a conference call for hospitals August 23 to discuss several topics related to inpatient...

• Uncover your facility's most common CCs and MCCs

  Coders' memory banks of their facilities' most common complications/comorbidities (CC) will have to...

• Let's get ICD-9 right before we move to ICD-10

  There are some things in ICD-9-CM that are just plain wrong. Some of these problems evolved when...

Issue 9, September 1, 2007 - VIEW THE FULL ISSUE

• CMS moves forward with MS-DRG system

  As expected, CMS finalized its plans to move ahead with a new Medicare Severity (MS) DRG system and...

• CMS adopts one of five proposed quality measures for 2009

  Collaborative approach could improve review process Now is the time for hospitals to refine...

• Consider the convenience of remote audits

  When a vendor reviews inpatient and outpatient medical records to gauge the accuracy and quality of...

• Address the new Important Message delivery requirements

  The rules for delivering the Important Message from Medicare went into effect on July 1, and now...

• Boost documentation improvement in the office

  So far, my columns have aimed at the acute-care setting and how understanding of diseases and code...

Issue 8, August 1, 2007 - VIEW THE FULL ISSUE

• ICD-9 revisions demand higher level of specificity

  CMS announced the proposed FY 2008 ICD-9-CM code revisions in June, and the aim of the new codes is...

• Switch to MACs imminent in seven regions of country

  The transition from fiscal intermediaries (FI) and carriers to Medicare administrative contractors...

• Make RAC-targeted DRGs a focus in your facility

  Although most hospitals are aware of the recovery audit contractor (RAC) demonstration project...

• What do you do when docs use the wrong terms?

  Terminology, semantics, alternative verbiage-the bane of a coder's existence! I had the...

• Coding Q&A

  Sandy Sillman, RHIT, PAHM, DRG coordinator for Henry Ford Health System in Detroit, answered the...

Issue 7, July 1, 2007 - VIEW THE FULL ISSUE

• Audit postacute transfers to ensure proper payment

  CMS has edits in place to alert your facility when it inappropriately receives the full DRG payment...

• CMS discusses POA indicator, revised IPPS calculations

  POA indicator The agency announced that it officially issued CR5499, CMS' instructions regarding...

• Tips to help tackle ongoing inpatient psych challenges

  Inpatient psychiatric facilities (IPF) have their own reimbursement and compliance challenges...

• Coding Clinic advice for aborted stroke cases sparks debate

  When a patient presents with an impending stroke and receives treatment to try to abort the stroke...

• Watch for 'complications of care' that didn't occur

  Many of us have been hearing horror stories about the 2008 IPPS proposed rule. We might lose some...

• Coding Q&A

  Coding Q&A

Issue 6, June 1, 2007 - VIEW THE FULL ISSUE

• CMS overhauls DRGs, CCs in IPPS proposed rule

  The IPPS proposed rule that CMS released April 13 would completely overhaul the current DRG system...

• Consider remote coding for your facility

  HIM and coding departments strive to find a way for their coders to produce a high volume of work...

• CMS discusses IPPS proposed rule, therapy, and more

  Editor's note: CMS hosted an Open Door Forum conference call for hospitals on April 19 to discuss...

• Survey shows mixed approach to doc improvement

  Editor's note: The following article reports on the results of two HCPro, Inc., surveys that asked...

• Coding Q&A

  Coding Q&A

Issue 5, May 1, 2007 - VIEW THE FULL ISSUE

• Coding coronary artery stenosis marked by confusion

  Unclear Coding Clinic advice regarding coronary artery stent stenosis has resulted in confusion...

• RAC program set to go national by 2010

  The time to prepare is now CMS has announced that the recovery audit contractor (RAC) program...

• Communication essential to documentation improvement

  Setting up a documentation improvement program is a lot of work. There are forms to develop...

• Make sure you measure the right data

  There have been several changes recently in the coding and reimbursement world related to DRGs, ICD...

• Coding Q&A

  Sandy Sillman, RHIT, PAHM, DRG, coordinator for Henry Ford Health System in Detroit, answered the...

Issue 4, April 1, 2007 - VIEW THE FULL ISSUE

• Improve accuracy with clinically-minded coding

  Prepare for changes like the POA indicator Coders are well-versed in the intricacies of the...

• Look into the severity DRG crystal ball

  Coders may see changes for better and worse Although CMS is moving toward a severity-adjusted...

• Watch for these criteria before seeking clarification

  Coding guidelines tell you to question certain documentation before assigning codes because a...

• Coding Q&A

  The mission of Coding Q&A is to help you find answers to your urgent coding/compliance questions...

Issue 3, March 1, 2007 - VIEW THE FULL ISSUE

• Look for the link when coding diabetes

  Diabetes coding brings plenty of documentation challenges. Educate yourself on the condition's...

• Integrate new coders with customized education, review

  The current lack of qualified coders means that facilities are more likely to hire inexperienced...

• Find the right incentive plan for your facility

  Chances are your coding department relies on two or three workhorse coders to consistently shoulder...

• Listen to the medical record

  Coders often become frustrated because the physician doesn't provide the information they need in...

Issue 2, February 1, 2007 - VIEW THE FULL ISSUE

• Physician advisor can increase the accuracy of coding/quality data

  Although coders are well-versed in the ICD-9-CM rules, they often have trouble decoding the...

• Create coding expectations based on goals, production

  Each organization has fiscal management goals, and understanding these goals will guide HIM...

• Revisit queries to ensure correct coding, reimbursement

  RAC focus, severity DRGs increase the importance of query management The physician query is a...

• Ongoing problems: Heart disease, mural thrombus, and more

  Although most HIM professionals delight in a greater understanding of the clinical aspects of the...

Issue 1, January 1, 2007 - VIEW THE FULL ISSUE

• Profiling data depend on documentation

  You're probably aware that earning the appropriate reimbursement depends heavily on physician...

• POA indicator paves way for severity-adjusted DRGs

  Although CMS is not fully rolling out a severity-adjusted (SA-DRG) system for fiscal year 2007, the...

• Seek specificity with sepsis codes

  Coding sepsis is difficult due to vague and overlapping terms that denote various degrees of severe...

• Cardiomyopathy is rarely 425.4

  The most commonly reported cause of cardiomyopathy (CMP) worldwide-all comers, all ages-is...