Chronic conditions are the driving force in determining healthcare outcomes and costs in today’s value-based world, hence the interest in the Hierarchical Condition Category (HCC) coding payment model. Coding chronic conditions and co-morbidities is becoming increasingly critical as the healthcare landscape shifts toward value-based care. Value-based care attempts to advance…
From evolving your CDI department to a population-centric approach to understanding the impact of electronic medical record technology on CDI program outcomes are among six resolutions offered by the author.Happy New Year! It’s now officially 2018, and even though we are already a full quarter into the federal fiscal year,…
CDI programs are viewed by most physicians as hospital-led initiatives geared towards increasing reimbursement for the hospital.The majority of clinical documentation improvement (CDI) programs fail to effectively engage physicians as willing participants in the push to accurately capture patient care provided through clear, concise, and contextually consistent reporting. Clinical documentation…
New quality measures have been added to the IRF Compare website in order to assist consumers, although some measures are not included.The Inpatient Rehabilitation Facility (IRFs) Prospective Payment System for federal fiscal year 2018 final rule published Aug. 3, 2017 included the addition of additional quality measures to the IRF…
Eight key guidelines for ensuring proper coding. EDITOR’S NOTE: The following is a summary of a presentation by Margaret Skurka during the 2017 American Health Information Management Association (AHIMA) national convention in Los Angeles. Evaluation and management (E&M) documentation principles have been around a long time – since 1995, in…
Much was covered during the ICD-10 Coordination and Maintenance Committee (C&M) meeting last week at the Centers for Medicare & Medicaid Services (CMS) headquarters in Baltimore.The first striking item was that there were no procedure proposals made during this meeting. There was discussion about three root operations – creation, control,…
The August heat is upon us here in the nation’s capital, and lawmakers have left town for their summer recess. The Senate was able to tie up some loose ends before leaving, including the passage of the Food and Drug Administration Reauthorization Act (FDARA), while leaving uncertainty regarding the reauthorization…
There has been a wide array of discussion through published articles, forums, webinars, and meetings about the topic of outpatient clinical documentation improvement (CDI) programs. Outpatient CDI is receiving much attention and experiencing traction in the healthcare industry due to providers coming to terms with the fact that documentation truly…
Here are some lessons learned over the last year as we have prepared for an organization-wide approach to implementing ICD-10 across a very large health system in San Diego. There are three specific areas that should be considered when  implementing a new coding process for hospice programs, which went into…
During recent months I have heard many references to Oct. 1 and ICD-10, but there have been fewer than expected following implementation of the new coding set. I was pleasantly surprised by the quiet. It was a good feeling, a feeling of accomplishment, knowing that all of us in the…