Revenue Cycle Newsletters

Briefings on APCs Briefings on Coding Compliance Strategies HIM Briefings Managed Care Contracting and Reimbursement Advisor Strategies for Health Care Compliance

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

Subscribe »

2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001

Issue 12, December 1, 2015 - VIEW THE FULL ISSUE

• Latest AHA Coding Clinic for ICD-10 covers orthopedic, cardiovascular coding

  Some interesting tidbits of information can be gleaned from the most recent release of the AHA...

• The CDI team's impact on the CMS pneumonia readmission measure

  The Hospital Readmissions Reduction Program (HRRP) is a CMS pay-for-performance program that links...

• Neonatal or not neonatal?

  The terms "newborn" and "neonatal" have different definitions depending on the...

• Meet the challenges of spinal arthrodesis coding in ICD-10-PCS

  Coding for spinal arthrodesis procedures has always been a challenge given the complexity of these...

Issue 11, November 1, 2015 - VIEW THE FULL ISSUE

• Predicting ICD-10 losses and tracking key performance indicators after October 1

  After several delays, ICD-10 implementation is finally upon us. The healthcare industry has spent...

• Adding venous thromboembolism to the CDI checklist at your facility

  The annual incidence of an initial venous thromboembolism (VTE) event, either a pulmonary embolus...

• Past is present: ICD-10-CM clears some ICD-9-CM issues while others persist

  I have been musing recently about things I've written for this journal over the past years. Hard to...

• Training tool: Choose the correct ICD-10-PCS root operations and devices

  Use this 10-question quiz to determine how well you understand ICD-10-PCS root operations and...

Issue 10, October 1, 2015 - VIEW THE FULL ISSUE

• Sepsis: Understand clinical presentation and coding strategies for ICD-10

  A 12-year-old male developed umbilical discomfort Monday and didn't eat much dinner. On Tuesday, he...

• Have you integrated CMS FY 2016 quality measures into your CDI program?

  Each new CMS fiscal year, MS-DRG weight and classification changes in the CMS IPPS final rule are...

• Picking last-minute ICD-10-CM/PCS priorities

  Dual coding. Reformatting queries. Educating physicians. Let's face it?the to-do list for ICD-10...

• CMS setting itself up for billions of dollars of wasteful spending in ICD-10

  Sometimes people do their homework with setting up a new system, and sometimes they don't...

Issue 9, September 1, 2015 - VIEW THE FULL ISSUE

• Identify ICD-10-PCS MS-DRG shifts

  ICD-10 implementation will arrive very soon, and many facilities are putting the final touches on...

• CMS focuses on value over volume in IPPS rule

  CMS continued its focus on improving the quality of patient care in the fiscal year (FY) 2016 IPPS...

• More chart review findings: Keep that education coming

  Robert S. Gold, MD, discusses educational opportunities for sequencing viral gastroenteritis...

Issue 8, August 1, 2015 - VIEW THE FULL ISSUE

• Identify orthopedic coding challenges

  Ask a physician why he or she documents in the medical record and you'll get a variety of answers...

• Details distinguish between Excision, Resection

  ICD-10-PCS root operations Excision and Resection differ only in how much of a body part is...

• CMS proposed minor changes to 2-midnight rule

  Although CMS did not propose any changes to the 2-midnight rule in the fiscal year 2016 IPPS...

• Identify opportunities from audits

  It's great, identifying opportunities to teach. Whenever I do medical record audits, I always look...

Issue 7, July 1, 2015 - VIEW THE FULL ISSUE

• Keep up with Coding Clinic for ICD-10-PCS

  With fewer than 100 days until ICD-10-CM/PCS implementation, plenty of questions still remain about...

• Focus on criteria for acute renal failure

  Physicians often use the terms acute renal failure (ARF) and acute kidney injury (AKI...

• When acute respiratory failure isn't really acute respiratory failure

  Respiratory failure, whether acute or chronic and whether following surgery or not, is one...

• Identify vulnerabilities related to PSI 12

  PSI 12 evaluates the hospital's risk-adjusted rate of perioperative deep vein thrombosis (DVT...

Issue 6, June 1, 2015 - VIEW THE FULL ISSUE

• Prepare for increased queries in ICD-10-PCS

  ICD-10-CM will still allow coders to report unspecified codes. However, coders will not have that...

• CMS continues focus on quality measures

  IPPS proposed rule includes ICD-10 codes, no changes for 2-midnight rule

• Drill down into Patient Safety Indicator 7

  In the third part of our series on Patient Safety Indicator 90, we focus on inclusions...

• Accidental laceration criteria misunderstood

  Robert S. Gold, MD, highlights areas of confusion involving PSI 15 guidance.

Issue 5, May 1, 2015 - VIEW THE FULL ISSUE

• Focus in on PSI 15 to improve reporting

  PSI 15 measures the hospital's risk-adjusted rate of accidental punctures and lacerations. PSI 15...

• ICD-10-CM adds a new concept with underdosing

  Take note of the changes and similarities between ICD-9-CM and ICD-10-CM.

• Conflicting documentation: The mechanisms of diagnosis inconsistency

  Robert S. Gold, MD, reviews how to identify conflicting documentation.

• Coding Clinic highlights mechanical ventilation, principal procedure sequencing

  Take a look at some of the most interesting areas discussed regarding the coding of surgical...

Issue 4, April 1, 2015 - VIEW THE FULL ISSUE

• Refresh your knowledge of CC/MCCs

  Even through ICD-9-CM and ICD-10-CM/PCS are currently under a code freeze, coders and CDI...

• Take a high level look CMS' PSI 90

  Patient Safety Indicator 90 evaluates hospital performance for defined in-hospital complications...

• Aftercare codes get a makeover in ICD-10-CM

  ICD-10-CM will resolve some of the confusion surrounding aftercare codes by using seventh...

• Tension over hypertension as we transition from ICD-9-CM to ICD-10-CM

  Robert S. Gold, MD, discusses hypertension in its various forms.

Issue 3, March 1, 2015 - VIEW THE FULL ISSUE

• Simplify coding, CDI concerns for complications

  It's not uncommon to see conditions arise in the postoperative period. The question is, are they...

• Get back to query basics

  The American Health Information Management Association (AHIMA) and the Association of Clinical...

• Consultants failing with heart failure

  Robert S. Gold, MD, explains when to skip the query on heart failure.

• House subcommittee hears from industry stakeholders on ICD-10

  On February 11, costs and plans took center stage at the ICD-10 implementation hearing held by the...

Issue 2, February 1, 2015 - VIEW THE FULL ISSUE

• Coding, CDI focus on heart disease differs

  Coronary artery disease (CAD) develops when the arteries that supply the blood to the heart muscles...

• Queries can help reflect accurate SOI, ROM

  Coding tells a patient's story, based on the narrative the physician provides in his or her...

• Coding Clinic continues to focus on ICD-10-PCS

  Many coders and CDI specialists memorized previous Official Guidelines for Coding and Reporting...

• Determine when to code a condition

  Coding professionals may inappropriately assign codes from parts of the medical record where the...

Issue 1, January 1, 2015 - VIEW THE FULL ISSUE

• ICD-10-PCS bypass is more than CABG

  Coronary artery bypass graft (CABG) procedures are not the only ones coders will report using the...

• Second Quarter advice on PCS coding and documentation

  Despite all the uncertainty surrounding the implementation of ICD-10-CM/PCS, the Cooperating...

• Know when to charge for ancillary bedside procedures beyond the room rate

  Inpatient coding professionals are used to DRG systems where all of the diagnoses and procedures...

• Know when to ask for more information

  Sometimes the physician's documentation is insufficient to represent what the patient actually...