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Briefings on Coding Compliance Strategies

Issue 12, December 1, 2011 - VIEW THE FULL ISSUE

• FY 2012 OIG Work Plan offers inpatient codersglimpse of potential audits

  The OIG has released its annual Work Plan, and ­inpatient coders need to be aware of several...

• Make time to review FY 2012 ICD-9-CM guidelines

  If you haven't already reviewed the FY 2012 ICD-9-CM Official Guidelines for Coding and Reporting...

• Proactive plans ease transition for coders, physicians

  Procrastination nearly always leads to less-than-stellar results. Waiting until the last minute is...

• Ensure compliant billing for replacement devices

  When hospitals receive full or partial credit for a replacement device, CMS reduces payment if the...

• Cardiomyopathy: Know intent of codes reported

  The goal of coding should always be ensuring data accuracy and capturing a patient's true clinical...

Issue 11, November 1, 2011 - VIEW THE FULL ISSUE

• Get ready for ICD-10-CM combination codes

  Comination codes take on an entirely different flavor in ICD-10; there are more of them than in...

• Medicare publication offers valuable coding tips

  A recent Medicare Quarterly Provider Compliance Newsletter calls attention to several specific...

• Don't fall prey to coding information overload

  How can coders avoid information overload while keeping pace with a steady stream of regulatory...

• Hypertrophic cardiomyopathy and ventricular hypertrophy

  Understanding how hypertrophic cardiomyopathy and ventricular hypertrophy differ is essential to...

• Advocate for thorough pneumonia documentation

  Pneumonia presents challenges for coders when physician documentation is unclear.

• Monitor diagnoses targeted for readmission reduction

  CMS is starting to crack down on readmissions, and hospitals may soon feel the effects from a...

Issue 10, October 1, 2011 - VIEW THE FULL ISSUE

• New ICD-9-CM diagnosis codes offer hint of what future holds

  Variety is often the spice of life, and this year's 168 new ICD-9-CM diagnosis codes seem to...

• Compliant reporting requires thorough analysis

  Is the condition truly a complication, or is it simply an expected outcome of surgery? Answering...

• Learn why the discharge summary is worth the wait

  Coding without a complete medical record could put your facility at risk during a RAC audit...

• Know the rules before you play the game

  Although age is not a factor for some medical conditions, others are age-specific or have...

• Carefully examine syncope and collapse denials

  Hospitals reported syncope and collapse (MS-DRG 312) as the top MS-DRG with respect to financial...

Issue 9, September 1, 2011 - VIEW THE FULL ISSUE

• FY 2012 IPPS final rule includes some surprises

  The FY 2012 IPPS final rule is out and hospitals that are bracing for changes effective October 1...

• Know how to identify, understand RAC compliance risks

  RACs use the Common Working File to ensure that hospitals are reporting discharge disposition...

• EHR success depends on physician engagement

  Learn why EHR success depends on physician engagement.

• Understanding how ICD-9, ICD-10 requirements differ

  Learn how diabetes coding differs in ICD-9 and ICD-10.

Issue 8, August 1, 2011 - VIEW THE FULL ISSUE

• Don't remain silent if you observe a pattern of fraudulent conduct

  Learn what two coders did when they realized the query process at Johns Hopkins Bayview Medical...

• Ensure compliance when reporting MS-DRG 813

  MS-DRG 813 (coagulation disorders), a RAC ­target during the demonstration program...

• Include physicians during transition to ICD-10

  As coders sharpen their knowledge of anatomy and physiology and hone their ICD-10-CM/PCS skills...

• Coping with principal diagnosis coding conundrums

  Knowing the guidelines and anticipating exceptions helps coders cope with principal diagnosis...

Issue 7, July 1, 2011 - VIEW THE FULL ISSUE

• Prepare now for Medicaid RACs

  Learn how to prepare for Medicaid recovery audit contractors.

• Take small steps to prepare for ICD-10-CM

  Review new code descriptions and added specificity to prepare for ICD-10-CM implementation.

• CMS releases top overpayment issues per RAC

  Anyone looking for more information about RAC ­findings mighty be happy to know that CMS has...

• Use the IPPS PC Pricer to monitor and predict potential outliers; don't let money go out the door

  Although certain inpatient outlier payments are ­justified, hospitals should always look...

• Inpatient coder productivity standards today and tomorrow

  HCPro survey reveals mixed opinions about anticipated effect of ICD-10 implementation on coder...

• 2011 Coder Productivity Survey

  Establishing coder productivity standards can be ­challenging if you don't know where to...

Issue 6, June 1, 2011 - VIEW THE FULL ISSUE

• 2012 IPPS proposed rule: What you need to know

  CMS has released its fiscal year (FY) 2012 IPPS proposed rule, and coders need to note various...

• Note details when drafting physician queries

  Learn how to choose your words wisely when drafting physician queries and understand why doing so...

• Use PEPPER to enhance your RAC readiness

  Learn how PEPPER can spice up your RAC compliance efforts.

• Rebilling patterns a potential red flag for RACs

  Learn how a frequent pattern of rebilling claims can raise a red flag for potential third-party...

• To query or not to query: That is the question

  How and when should you use information in the medical record when querying physicians?

Issue 5, May 1, 2011 - VIEW THE FULL ISSUE

• Inpatient-only procedures: Ensure compliance, avoid RAC recoupments

  Inpatient coders may lack familiarity with the ­inpatient-only procedure list because CMS...

• Consider remote coding to attract top-notch professionals

  If you've ever experienced difficulty finding coders with the appropriate credentials and...

• Know how ICD-10 could affect your bottom line

  Exactly how will ICD-10 affect MS-DRG assignment?  As coders began learning the intracacies of...

• HAC data goes public: Is your hospital ready?

  If you haven't already heard, HAC data is now publicly available on CMS' website, and as of April...

• Note the intent of ICD-9-CM codes you report

  Coders sometimes get into the habit of assigning codes simply because they see diagnoses written in...

Issue 4, April 1, 2011 - VIEW THE FULL ISSUE

• Take proactive approach to PACT compliance

  RACs continue to keep a close eye on the Post-Acute Care Transfer (PACT) policy that reduces the...

• Nine tips to help improve physician queries

  Experts offer suggestions for crafting effective physician queries.

• Correctly code adverse effects, poisonings

  Did the patient have an adverse effect from a specific drug, or was it a poisoning?  The...

• CMS proposes value-based purchasing incentives

  CMS has proposed a hospital value-based purchasing program that would provide financial incentives...

• Coding is a tough job, but someone has to do it

  What role do coders play in a healthcare environment where automated coding is becoming...

Issue 3, March 1, 2011 - VIEW THE FULL ISSUE

• Let body of operative report guide code assignment

  Operative reports can be a gold mine of information, far surpassing often vague or generalized...

• increased coding compliance, improved productivity?

  If you haven't already considered adopting computer-assisted coding (CAC) software, there's no time...

• Condition code 44: Going back to basics

  Knowing when to admit patients rather than place them in observation is an important part of any...

• Quick tip: Know the factors that affect CMI and how to communicate this information to your CFO

  Coding managers and their teams should be (and generally are) aware of code and DRG changes as well...

• BCCS advisors share their ICD-10 coding insight

  What is the most significant change facing coders as of October 1, 2013, and what can they do to...

• Cardiomyopathy, dysfunction, heart failure

  Coders often are befuddled by information in the medical record that makes determining a patient's...

Issue 2, February 1, 2011 - VIEW THE FULL ISSUE

• Know when to report secondary diagnoses

  A patient’s medical record could include a laundry list of diagnoses, but not all of these...

• Always remember to dig deeply in documentation whenever you assign the POA indicator

  How often have you encountered this frustrating, yet all-too-common scenario?  You’re...

• Understand medical, surgical root operations

  When ICD-10 takes effect October 1, 2013, the number of inpatient procedure codes will grow...

• Always beware of any bad coding advice you receive

  During this audit-intensive climate and time of economic hardship, hospitals want to ensure that...

Issue 1, January 1, 2011 - VIEW THE FULL ISSUE

• Know which coding issues to include in your facility’s 2011 audit plan

  With an ever-growing list of RAC-targeted MS-DRGs and a host of coding compliance traps that...

• Ensure thorough inpatient rehabilitation documentation

  Now that medical record audits are the rule rather than the exception, inpatient rehabilitation...

• Address high-risk coding issues when preparing for RAC audits at your organization

  Want to know what RACs may hone in on next?

• Got coding questions? I have answers!

  When a coding or clinical question arises, know that you’re not the only coder asking the...

• Briefings on Coding Compliance Strategies 2010 index

  Briefings on Coding Compliance Strategies 2010 index

• Coding Q&A

  Editor’s note: Answers to the following questions are based on limited information submitted...