Facilities are urged to re-double coder training and education. Coders and auditors are taught to be diligent for the high frequency, high cost, and problem-prone cases as these topics are the focus on third-party reviewers. What does that mean for the new coder? The new coder may not be aware…
Ten things to consider before outsourcing your healthcare needs.  I have spent a good part of the past 10 years in the healthcare industry, immersing myself in the workings of foreign countries as it relates to coding, billing, compliance, HIPAA, Protected Health Information (PHI), etc., and have found that there…
The author responds to a Talk Ten Tuesday listener's comments regarding the coding of bronchoalveolar lavage. During the Talk Ten Tuesday broadcast on July 24, 2018, Stacey Elliott, an inpatient compliance specialist and a guest panelist on program, and I had a discussion regarding bronchoalveolar lavage (BAL). Stacey had a…
Coders are encouraged to learn more about the clinical conditions associated with the patient encounters they are coding. As coders, we often struggle with assigning the correct codes. There are many gray areas in the guidelines and instructional notes, and sometimes even conflicting information can be found. This leads to…
Newly covered treatment offers promising relief for sufferers of condition tied to poor blood circulation in the legs.  The main symptom of peripheral arterial disease (PAD) is intermittent claudication. This is an aching, cramping, tired, and sometimes burning sensation in the legs that comes and goes – it typically occurs when walking…
Communication, collaboration, and coding exemplify the tone of last week’s C & M meeting. “Communication, collaboration, and coding” are three words that describe the March 6 and 7 ICD-10 Coordination and Maintenance meetings in Baltimore last Tuesday and Wednesday. The meetings were conducted at the headquarters of the Centers for…
Recently I reviewed a case that triggered an exposition. As a clinician, I am always trying to wrap my head around a coding-clinical disconnect in the ICD-10-CM Official Coding and Reporting Guidelines regarding poisoning versus adverse effects. All medications have side effects; a clinician considers the cost-benefit ratio of each…
Understanding when and how to use clinical documentation integrity internal clinical guidelines (CDI-ICGs) Clinical policies, clinical practice guidelines, best practice advice: there are numerous ways to refer to written recommendations designed to spell out how best to diagnose and treat patients based on the most current evidence. These are developed…
Are claim rejections impacting reimbursement at your facility? Is your facility experiencing the consequential reduction in revenue stream since the advent of ICD-10?