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Issue 12, December 1, 2012 - VIEW THE FULL ISSUE

• It's time to begin thinking about resolutions for 2013

  The new year is right around the corner, and we'll be another year closer to the ICD-10-CM/PCS...

• Powerful antidotes to cure ICD-10-PCS fears

  ICD-10-PCS may prove to be far more challenging for inpatient coders than ICD-10-CM. For some, it...

• Major joint replacement and medical necessity

  Have you read MLN Matters® article SE1236 lately?

• Are coders receiving questionable advice?

  Robert S. Gold, MD, gives coding guidance on primary cardiomyopathy, SIRS, sepsis, acute...

• Test your knowledge with some challenging Q&As

  Inpatient wound care coding has always been fraught with documentation challenges.

Issue 11, November 1, 2012 - VIEW THE FULL ISSUE

• ICD-10: Continuing momentum will facilitate transition

  The ICD-10-CM/PCS delay may give coders more time to learn the new system, but what does this mean...

• Establish a game plan for ICD-10 queries

  ICD-10-CM/PCS incorporates laterality, acuity, anatomical specificity, and a slew of additional...

• Case study: Hospital to use CAC for ICD-10 preparation

  The manager of clinical documentation integrity program/HIMS at a 300-bed academic medical center...

• Ethical dilemmas require proactive approach

  Ethical dilemma. These two words make coders cringe.

• New information about ­metastatic neoplasms

  Every few years, the AHA publishes guidance in Coding Clinic that can significantly affect...

Issue 10, October 1, 2012 - VIEW THE FULL ISSUE

• How will the changes empower coders to improve compliance?

  Coders play a crucial role in ensuring compliance, and the FY 2013 IPPS final rule, released August...

• Accuracy helps avoid denials, ensure compliance

  Inpatient-only procedures are those that CMS has determined providers must perform on an inpatient...

• Review new asthma terminology in ICD-10-CM

  Intrinsic. Extrinsic. Chronic obstructive. These are just some of the terms that describe asthma in...

• How will this technology affect productivity?

  Now that CMS has finalized a 2014 implementation date for ICD-10-CM/PCS, increasingly more...

• Put BMI in context, consider potential risk factors

  As you may know, ICD-9-CM V codes have been expanded to include higher body mass indexes (BMI...

Issue 9, September 1, 2012 - VIEW THE FULL ISSUE

• Coma, stroke codes require more specific ­documentation

  A quick glance at ICD-9-CM and ICD-10-CM stroke and coma codes reveals many similarities and some...

• Ask questions before reporting complications

  Complications are … well, complicated. There's no other way to say it. Why are they so...

• Some codes evolve more slowly than others

  ICD-9-CM codes invariably change over time. Some changes are for the better, and some are for the...

• Consider self-audit before responding to request

  Do you audit records before sending them to your Recovery Auditor? If not, your hospital may be one...

• Add PEPPER data to your audit program

  Information received by TMF Quality Institute during the past year indicates that 61% of hospitals...

• Help physicians understand what coders need

  Coding managers and their team members sometimes must approach physicians in person regarding...

Issue 8, August 1, 2012 - VIEW THE FULL ISSUE

• Thorough ­documentation review helps ensure ­accurate principal diagnoses

  Clear and consistent documentation makes a coder’s job much easier, and it improves data...

• Coders skills are crucial for successful EHR rollout

  Should coders or coding managers be involved in an EHR rollout? The answer to this question is...

• Clarify IBS and IBD before you assign codes

  Physicians often use the acronyms IBS (which should indicate irritable bowel syndrome) and IBD...

• Start learning new ICD-10-CM fracture codes

  The sheer number and detail of new fracture codes in ICD-10-CM is daunting, leaving many coders to...

Issue 7, July 1, 2012 - VIEW THE FULL ISSUE

• What to expect when coding CAD, MI with ICD-10-CM

  ICD-10-CM coronary artery disease and myocardial infarction codes will undoubtedly differ from...

• Recovery Auditors focus on three-day rule

  Learn why June 25, 2010 is important within the context of three-day payment rule audits.

• New criteria could help ensure consistent coding

  New clinical guidelines for malnutrition could help alleviate compliance challenges associated with...

• Pondering causes of mechanical, paralytic ileuses

  Robert S. Gold, MD ponders the causes of mechanical and paralytical ileuses.

• Emphasize importance of history of present illness

  Inpatient coders don't typically assign E/M codes, but they should be aware of documentation of the...

Issue 6, June 1, 2012 - VIEW THE FULL ISSUE

• Continue preparations despite proposed delay

  CMS has proposed delaying ICD-10 implementation until October 1, 2014, but coders shouldn't delay...

• MAC prepayment reviews hit hospitals hard

  MACs have already begun prepayment reviews at hospitals nationwide, and Medicare Recovery Auditors...

• Seven savvy tips for coding sepsis and SIRS

  Many physicians say that SIRS criteria are insufficient and confusing at best, and don't indicate...

• Address medical necessity, coding challenges

  Medical necessity denials traditionally focus on high-dollar DRGs, such as those for hip and knee...

• Will acute respiratory failure be CC instead of MCC?

  Will acute respiratory failure be demoted from MCC to CC?

• Quality of care emerges as FY 2013 theme

  Inpatient hospitals will see CMS payment rates increase 2.3% in FY 2013 if the agency finalizes the...

Issue 5, May 1, 2012 - VIEW THE FULL ISSUE

• Delayed implementation and its effect on coders

  The wait is over-CMS has announced a proposed rule that would postpone ICD-10 implementation from...

• Are your ICD-10 implementation fears justified?

  Does ICD-10 really merit all the worry—particularly for coders?

• Review guidelines for coding pregnancy, its complications

  Depending on the demographics of the region a hospital serves, its coders could determine code...

• Take time to learn what motivates your coding staff

  When more is expected of coders, more motivation is necessary to help them achieve their full...

Issue 4, April 1, 2012 - VIEW THE FULL ISSUE

• Coders need to understand their role in the process

  Coding isn't just about reading documentation and selecting codes based on certain words...

• Planning can maximize benefits of internal coding audits

  If you're going to spend time and resources to conduct a coding audit, you certainly want to ensure...

• Identify potential Medicaid RAC target areas

  The Medicaid RAC program kicked off January 1, and experts say that although the program got off to...

• Consider the big picture before querying physicians

  If there's a valid reason to query, get your ducks in a row before doing so.

• Know how to translate physician ­documentation

  Experts say ICD-10-PCS may be more challenging for coders coding procedures than for...

Issue 3, March 1, 2012 - VIEW THE FULL ISSUE

• Clinical evidence offers clues

  Knowing when and how to query for all conditions is crucial; this couldn't be truer for CCs and...

• Prospective process helps identify PACT underpayments

  Learn why a 1% error rate in discharge status code assignment is not as insignificant as it might...

• Don't jump to conclusions about documentation

  Learn how coders are led astray by bad data and physician documentation that isn't entirely...

• Strive for specificity now and in preparation for ICD-10

  ICD-10 will allow coders to report nonspecific, unspecified, or not otherwise specified (NOS...

• Cross-train coders to prepare for ICD-10 implementation

  Cross-training coders has definitive short-term advantages, such as enhancing staff coverage during...

• Providers assess prepayment, rebilling demonstrations

  CMS has been busy, particularly with its newly ­announced Recovery Audit prepayment review and...

Issue 2, February 1, 2012 - VIEW THE FULL ISSUE

• CMS demonstration allows rebilling outpatient services after some inpatient denials

  Perhaps you're familiar with the following scenario: A hospital submits a short-stay inpatient...

• CMS announces MS-DRGs set for prepayment review

  RACs will soon have authority to ­review claims before they're paid to ensure that providers...

• Know how inpatient coders can ensure compliance

  The three-day payment window requires hospitals to include the following information on inpatient...

• Review ICD-9-CM guidelines for coding pain

  Generally speaking, coders are taught not to code signs and symptoms that are integral to a disease...

• Respiratory failure code description limitations

  In March 2011, the ICD-9-CM Coordination and Maintenance Committee updated the following code...

• Understand new ICD-10-CM coding conventions

  ICD-10-CM will bring some new coding conventions.

Issue 1, January 1, 2012 - VIEW THE FULL ISSUE

• Bundled payment plan aims to improve care, lower costs

  Hospitals have long lamented the difficulty of obtaining physician buy-in for various quality...

• Is computer-assisted coding friend or foe?

  Learn what you need to know about computer-assisted coding.

• Scrutinize documentation in 2012 and beyond

  Even if you don't make a personal New Year's resolution, you should make a professional one: to be...

• New ingredients in CMS' regulatory alphabet soup

  By now, you're probably familiar with Medicare hospital-acquired conditions (HAC) and know that...

• BCCS 2011 index

  Briefings on Coding Compliance Strategies 2011 Index