More than 4,000 cases were coded in the 2019 contest focused on outpatient coding. ICD-10 is well-established, and we are already discussing and planning for ICD-11. However, where are the long-anticipated and promised increased accuracy and most definitive diagnoses? At least one coding contest found outpatient coding in 2019 had…
Proactive measures in claim denial management can recoup lost revenue. Unfortunately, the majority of healthcare organizations encounter claim denials on a regular basis, often, habitually. Though claim denials may be an unavoidable reality in the world of healthcare, ineffective claim denials management can result in even more lost revenue. A…
Tips for improving outpatient coding, CDI and billing. In moving from inpatient clinical documentation improvement (CDI) to outpatient CDI, I have been discovering some unique educational pointers. I know we are all very busy, so let’s just dive right into it. Doctors and coders, you should not have diagnoses that…
New billable CPT® codes for monitoring patients who are taking blood-thinning medications. In 2018, CPT® deleted codes 99363 and 99364 and replaced them with codes 93792 and 93793. There are two important things to know about coding for international normalized ratio (INR) monitoring, also known as a “protime check” (PT).…
A Pittsburgh-based MD weighs in on an emerging area of focus in the healthcare industry. EDITOR’S NOTE: The following are remarks made by the author during a recent broadcast of Talk Ten Tuesdays. Today I would like to focus on outpatient clinical documentation improvement (CDI), often referred to as the…
There is a definite need for outpatient CDI programs – provided that hospital administration takes the right approach to its development and implementation. Interest in outpatient clinical documentation integrity (CDI) programs is multiplying as more and more hospital services are moving to the outpatient setting and healthcare reimbursement models are…
EDITOR’S NOTE: The following is the third and final installment in a three-part series by Dr. Remer on outpatient clinical documentation integrity.In the first two parts of this series, we talked about risk adjustment in general, the shift to population health management, and how quality metrics and reimbursement are linked…
EDITOR’S NOTE: The following is the second installment in a three-part series on outpatient clinical documentation integrity.In Part 1 of this series, we detailed the concept of risk adjustment and how historically, the healthcare industry rewarded volume under the fee-for-service (FFS) model. The Centers for Medicare & Medicaid Services (CMS)…
EDITOR’S NOTE: The following a part of a series on outpatient clinical documentation integrity (CDI). Part IV was published on May 16, 2017 in the ICD10monitor e-News.The medical record serves primarily as a physician’s communication tool for patients and all associated healthcare stakeholders. The effectiveness and completeness of the documentation…
EDITOR’S NOTE: The following is part one in a three-part series on outpatient clinical documentation integrity.There is a great push within the healthcare industry to move clinical documentation integrity (CDI) into the outpatient arena. People refer to this as “outpatient CDI,” but I think this is a misnomer. If you…
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