Health Information Management

Tips to keep your coding compliance program fresh

HIM-HIPAA Insider, March 16, 2010

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Just because your coding compliance program is in place doesn’t mean it’s doing its job effectively. The following are tips from industry experts to keep your program from becoming stagnant:
  • Collaborate with other departments, says Dinh Nguyen, principal at Healthcare Compliance Solutions, LLC, in Los Angeles. Risk management, performance improvement, the revenue cycle, and finance departments should work together to identify or detect new risk areas that affect coding compliance. The coding staff also needs to communicate with the medical staff and provide feedback regarding whether documentation supports code assignment.
  • Develop and implement a clinical training program, says Glenn Krauss, RHIA, CCS, CCS-P, CPUR, an independent coding consultant in Milton, WI. The program should address and correct coding staff members’ clinical knowledge deficiencies. Tailor the program to meet individual staff members’ needs. Enhancing coders’ clinical knowledge is important because a significant number of coding oversights and errors identified during the recovery audit contractor demonstration program pertained to misinterpretation of clinical documentation. Greater clinical knowledge also will help coders know when a query is necessary and ensure correct assignment of the principal diagnosis and all relevant secondary diagnoses.
  • Focus on communication, says Andrea Merritt, compliance specialist at Hall, Render, Killian, Heath & Lyman in Troy, MI. Compliance officer must communicate frequently with the rest of the organization. Compliance newsletters are one way to convey the importance of compliance. Another way is sponsoring a compliance week during which the compliance officer can highlight the importance of compliance with quizzes, contests, and other activities.
Editor’s note: For additional tips, view the March 2010 issue of Briefings on Coding Compliance Strategies.

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