Health Information Management

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!

    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