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Issue 12, December 1, 2009 - VIEW THE FULL ISSUE

• New E codes require detailed documentation

  We’ve all read or seen news reports about horrific accidents that occur when people send...

• OIG focuses on hot-button issues in 2010 Work Plan

  Readmissions, the POA indicator, and adverse events are just some of the issues that top the 2010...

• Identify and audit top MIC targets

  Contractor combat. These are the two words that many compliance experts use to describe...

• Think twice before querying for clarification

  Physicians sometimes lose faith in coders and clinical documentation improvement (CDI) specialists...

Issue 11, November 1, 2009 - VIEW THE FULL ISSUE

• Prepare for ICD-10 with anatomy/physiology education

  As part of your preparation work for ICD-10, consider ways to offer coders more education on...

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

  The 2010 IPPS final rule included several changes related to MS-DRGs, complications and...

• Update your ICD-9 knowledge

  Some of the major code groupings undergoing change this year include more specificity to the...

• Complications of surgery, uncertain diagnoses, and more highlight important updates for coders

  The American Hospital Association’s Coding Clinic for ICD-9-CM is one of the most important...

• Revisit these common coding issues

  Each time I do an audit of medical records, I find documentation or coding issues that demonstrate...

Issue 10, October 1, 2009 - VIEW THE FULL ISSUE

• Use productivity benchmarks to set coding standards

  With audit contractors scrutinizing coding accuracy and an upcoming transition to the ICD-10 coding...

• Roller-coaster fall results in complex injuries

  Editor’s note: Test your coding skills with this case study from DeAnne W. Bloomquist, RHIT...

• Know how code assignment affects data quality and risk adjustment

  Coding has continually evolved over the past 10 years, and it will continue to change with the...

• Pay attention to the details to avoid upcoding

  Although undercoding is always a concern for facilities, potential upcoding is just as serious a...

• Update: Know the changes for coding anemia due to chemotherapy

  In the September BCCS, we published an article with Coding Clinic advice on coding anemia secondary...

• 2010 ICD-9-CM updates: Dealing with some of the code changes

  Venous disease changes Let’s start with the concept of “acute” and...

Issue 9, September 1, 2009 - VIEW THE FULL ISSUE

• CMS delays documentation and coding adjustment, reduces payment for common MS-DRGs

  CMS delayed a payment reduction, but changed MS-DRG weights.

• NCDs clarify how to identify and report never events

  Our experts help interpret CMS’ national coverage determinations, which include...

• Expect CMS outreach in preparation for Medicaid audits

  CMS officials talk about where the MIC program is heading and how they will educate providers.

• Coders need specific details before coding anemia secondary to chemotherapy

  Our coding experts provide three questions to ask before reporting anemia secondary to chemotherapy.

• Decode the language of physicians

  Robert S. Gold, M.D., helps coders decipher physician language in order to code hypertension and...

Issue 8, August 1, 2009 - VIEW THE FULL ISSUE

• What would you do? Know your ethical obligations

  In late June, Johns Hopkins’ Bayview Medical Cen¬ter in Baltimore agreed to pay nearly $3...

• Improve documentation with strong CDI specialist, program

  More hospitals will likely develop clinical documentation improvement (CDI) programs as ICD-10...

• Dissect documentation for psychiatric inpatients

  Unlike acute care inpatients, hospitals get paid for psych inpatients based on per diem rates set...

• Quick list: Eight tips to better understand CMS’ GEMs

  To help facilities prepare for ICD-10, CMS has pub¬lished two fact sheets that provide general...

• Know the adverse effects of atrial fibrillation

  A few months ago, I wrote a description of how atrial fibrillation (AF) with rapid ventricular...

Issue 7, July 1, 2009 - VIEW THE FULL ISSUE

• Uncover this helpful GEM to assist with ICD-10 transition

  Despite the fact that ICD-10 implementation is nearly three years away, CMS is ramping up its...

• The quick list: Eight recovery audit contractor refreshers

  In August, the recovery audit contractor (RAC) program will extend to all states nationwide. In...

• Is your hospital owed money for PACTs?

  The job of the recovery audit contractors (RAC) is twofold: Identify overpayments to recoup excess...

• Clinically Speaking: Demand a code for demand myocardial infarction

  Each year, the Cooperating Parties make changes to various ICD-9 code sets. Most recent changes...

Issue 6, June 1, 2009 - VIEW THE FULL ISSUE

• 2010 IPPS proposed rule brings historic payment lows, few coding changes

  When CMS released its May 1 proposal, hospitals received a mixed bag of news: There are minimal...

• CMS discusses RACs, ICD-10, and wage indexes

  During its most recent Open Door Forum, held May 6, CMS discussed several inpatient-related topics...

• Perspectives on chronic left ventricular heart failure: A coder and a physician team up to offer guidance

  Selecting a code for a patient with heart failure used to be fairly straightforward; fewer codes...

• Sequence properly for appropriate DRG assignment

  Every so often, I’m reminded of how important it is to code accurately and in the proper...

Issue 5, May 1, 2009 - VIEW THE FULL ISSUE

• OIG Work Plan: Still time to prepare

  Four aspects of the 2009 OIG Work Plan apply to inpatient hospitals and coders. Find out how you...

• California's hospital quality-data reporting success

  With the increased focus on quality of care, it comes as little surprise that California, one of...

• Understand inpatient wound care coding for RAC audits

  Two ICD-9 codes denote debridement in relation to wound care: 86.22, excisional debridement of...

• The quick list: Eight sepsis coding tips

  Sepsis, septicemia, bacteremia and Systemic Inflamma¬tory Response Syndrome (SIRS) are...

• Coding advice about a couple colonitises

  A variety of codes apply to certain dis¬eases of the large bowel, so it?s important to understand...

Issue 4, April 1, 2009 - VIEW THE FULL ISSUE

• Understand how never events, HACs differ

  Three new national coverage determinations are the latest steps in CMS’ initiative to...

• Championing the compliance cause: A coder's perspective on avoiding seven potential coding traps

  Coders have a moral and ethical responsibility to judiciously avoid reimbursement fraud and abuse...

• CMS discusses RACs, MACs, and AHRQ measures

  During its most recent Open Door Forum (ODF) on February 25, CMS discussed several...

• Straight talk about uncontrolled diabetes

  We’ve been in the medical record documentation business a long time, and we’ve heard...

Issue 3, March 1, 2009 - VIEW THE FULL ISSUE

• ICD-10 at long last: Prepare for implementation by 2013

  On January 15, CMS released two final rules: one mandating a switch from ICD-9-CM to the more...

• New guidance for coding BMI and pressure ulcers

  Hospitals around the country face a new challenge: teaching coders that they can, in certain...

• The coder’s new role in the revenue cycle

  Without complete and ac¬curate code assignment in conjunction with timely cod¬ing and...

• ’Injury’ hurts data integrity streams

  Physicians use the word “injury” because they read it in the current literature or...

Issue 2, February 1, 2009 - VIEW THE FULL ISSUE

• Don't leave money on the table: Report eligible procedures under OPPS

  Effective January 1, coders can report HCPCS code C9899 when providers implant a prosthetic device...

• Callers comment on HACs during special CMS session

  For more than a year, coders have reported the present-on-admission (POA) indicator for most...

• Take another look at observation 

  Revisit definitions, condition code 44, and the connection to inpatient status

• Falls, spills, and other uncodable events 

  Seek clarification regarding etiology  by Robert S. Gold, MD  Patient falls account for...

Issue 1, January 1, 2009 - VIEW THE FULL ISSUE

• Update physician query policy in light of new AHIMA practice brief

  Editor’s note: Last month in BCCS, we offered an overview of AHIMA’s new query brief...

• Guidelines for reporting CRT-D pacemaker implantation

  Be aware of new Coding Clinic advice Cardiac resynchronization therapy defibrillator (CRT-D...

• Briefings on Coding Compliance Strategies 2008 index

  AHIMA’s draft query practice brief leaves many questions unanswered. July, p. 1. Alleviate...

• Accurately document hemorrhage severity

  Get to know your bleeds to ensure proper coding by Robert S. Gold, MD Consider the following...