When acute respiratory failure isn't really acute respiratory failure
HIM-HIPAA Insider, July 27, 2015
Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!
We are familiar with payment structures as they relate to DRGs or MS-DRGs or per-diem rates or medical necessity elements, as well as the fact that payers for healthcare delivery don't like to pay for diseases that a patient doesn't have.
In some circumstances, a particular diagnosis code will be interpreted as a comorbidity or major comorbidity, or a disease that deserves a particular length of stay and associated cost factors. In other circumstances, a code may act as an inhibitor to getting paid, as in the case of hospital-acquired conditions, or as a ding against the good name of the hospital, as with Patient Safety Indicators or potentially preventable conditions.
Respiratory failure, whether acute or chronic and whether following surgery or not, is one diagnosis that is always an easy target for those who abuse the documentation and assignment of ICD codes.
Continue reading “When acute respiratory failure isn’t really acute respiratory failure” by Robert S. Gold, MD, on the HCPro website. Subscribers to Briefings on Coding Compliance Strategies have free access to this article in the July issue.
Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!
Related Products
-
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
- Articles
-
- Note similarities and differences between HCPCS, CPT® codes
- Know the medical gas cylinder storage requirements
- Steps for maintaining patient privacy
- Don't forget the three checks in medication administration
- Poor documentation: The consequences
- The consequences of an incomplete medical record
- Practice the six rights of medication administration
- Complications from immobility by body system
- OB services: Coding inside and outside of the package
- ICD-10-CM coma, stroke codes require more specific documentation
- E-mailed
-
- Q&A: Coding drug administration for observation patients
- Update: E/M pay cut tied to modifier 25 affects only certain payer plans
- Q/A: Coding 'in and out' bladder catherizations
- Performing a SWOT analysis
- MDS 101: How to train the MDS newbie
- Five ways to safeguard your patients' valuables
- Don't bill 59025, 76818 separately without separate physician orders
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Coding Clinic for CDI:Reassessing debridement documentation
- Searched