Health Information Management

News: Coding Clinic wins out over SE MLN Matters article advice

CDI Strategies, November 11, 2010

Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!

On October 14, we reported that CMS issued a controversial MLN Matters special edition (SE) article which stated that all inpatient admissions needed to have any/all ‘other’ or ‘secondary’ diagnoses documented by the attending physician.

The advice, published in article 1028, “Recovery Audit Contractor (RAC) Demonstration High-Risk Diagnosis Related Group (DRG) Coding Vulnerabilities for Inpatient Hospitals” was later rescinded as the guidance directly contradicted advice from Coding Clinic.
 
The new version of SE1028 has removed this language. You can read the revised article here on the CMS website.
 
The ICD-9-CM Official Guidelines for Coding and Reporting.indicate that “provider” is defined as a physician or other provider legally accountable for establishing a patient’s diagnosis. This could include specialists and others caring for the patient, who are not the patient’s attending physician.
 
Special thanks go to Robert Gold, MD, of the ACDIS advisory board for helping to bring this to the attention of CMS, and Lynne Spryszak and Shannon McCall also of the ACDIS advisory board for discovering the problematic language in the original article.

Editor’s note: This article first appeared on the ACDIS Blog. Read additional analylsis of the change in the MedicareMentor Blog



Want to receive articles like this one in your inbox? Subscribe to CDI Strategies!

    Briefings on APCs

  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular