News

With good collaboration and the right team members, continual improvements are attainable.Recently I have been engaged in a project of continual improvement in our clinics, and as chief compliance officer, I am continually looking for ways we can stay compliant, deliver excellent healthcare, and fix revenue leaks.We audit our physicians…
New code proposals from the ICD-10 Coordination and Maintenance Committee Meeting are discussed. The Coordination and Maintenance Committee met on September 11-12, 2018 to discuss new code proposals, as well as proposals that were previously presented. The presentations began with ICD-10-PCS proposals, with completion by mid-afternoon on the second day.…
The aftermath of Florence prompts a review of emergency preparedness We know the 2018 hurricane season is upon us, but we are always unsure of where the individual storms will appear, what their track will be, and how they will behave. Hurricane Florence—since downgraded to a tropic depression— has been…
Skin biopsy codes are changing. EDITOR’S NOTE: This is an updated version of the second installment in a two-part series on the 2019 CPT® codes released recently by the American Medical Association.For many years we have used two codes to report skin biopsies. CPT® 11100 for the first lesion and…
A review of Major Disease Category 18, Infectious and Parasitic Diseases, Systemic or Unspecified Sites. Systemic inflammatory response syndrome, or SIRS, due to a noninfectious cause can be confusing. SIRS caused by noninfectious conditions occurs in medical and surgical cases alike. Coding guidelines prohibit the use of codes R65.10, noninfectious…
The authors discusses the lawsuit against Providence St. Joseph Health Services for alleged upcoding. Performance with a purpose must be the driving force for business operations, personal goals, work and life accomplishments, and personal choices. The concept of performance with purpose must be a fundamental foundation governing all aspects of…
Recent FCA activity focuses on coding compliance issues Recently in healthcare news were articles about two legal actions that cause one to reflect on the need for a strong (or stronger) coding and clinical documentation improvement (CDI) compliance programs.  The first legal action cited the False Claims Act (FCA) and…
ICD-10-CM supports this new classification system. Four major cardiology associations have once again collaborated to update the universal standard definition of myocardial infarction (MI), and this effort was more ambitious than any prior effort. In a document published simultaneously by the American College of Cardiology (ACC), the American Heart Association…