Preparing for an HCC Audit: Good Documentation is Key
Preparing for an HCC Audit: Good Documentation is Key By Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA | April 24th, 2024| By Rose T. Dunn, MBA, RHIA, CPA, FACHE Good documentation is the best defense against a negative audit outcome. We often find ourselves grousing about Dr. X who never documents something or Dr. […]
Denial Rates in the Danger Zone: Coding to Withstand Audits
Denial Rates in the Danger Zone: Coding to Withstand Audits By Angela Lima, BS, CCS, CDIP, COC, CIC | March 29th, 2024 | By Angela Lima BS, CCS, CDIP, CIC, COC, AAPC-Approved Instructor “One-third of US hospitals’ average denial rates are in ‘danger zone,’ survey finds” Did this catch your attention? An article in Becker’s […]
ICD-11 Content Compared to ICD-10-CM
ICD-11 Content Compared to ICD-10-CM By Mary H. Stanfill, MBI, ACHIP, RHIA, CCS, CCS-P, FAHIMA | April 19th, 2024 | By Mary H. Stanfill, MBI, ACHIP, RHIA, CCS, CCS-P, FAHIMA Content analysis is a key consideration in evaluating a new code set. This involves examining the content and level of detail represented in each code […]
PEPPER Reports: Identifying Audit and Compliance Risks for your Organization
PEPPER Reports: Identifying Audit and Compliance Risks for your Organization By Cynthia Tang, RHIA, CCS | April 19th, 2024 | Coders’ Corner | By Cynthia Tang, RHIA, CCS Your PEPPER report is an excellent source of insight into areas of potential risk and specifically to provide guidance on where to focus your hospital’s auditing and […]
Updating the Facility-Specific Coding Guidelines: Part 1
Updating the Facility-Specific Coding Guidelines: Part 1 By Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer – April 8, 2024 EDITOR’S NOTE: This series is based on the “Developing Facility-Specific Coding Guidelines” which is an AHIMA Practice Brief. This practice brief was updated in December 2023. It also contains an Excel tool to […]
ICD-10-CM: Overview of Traumatic Fractures
ICD-10-CM: Overview of Traumatic Fractures By Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA Traumatic fractures are coded in ICD-10-CM chapter 19. Within the categories that describe fractures, subcategories identify the most common types of fractures for the specific bone identified in that code category. Terms such as transverse, spiral or comminuted can be found in these […]
Billing for Non-Physician Practitioners: Split-Shared and Incident-To
Billing for Non-Physician Practitioners: Split-Shared and Incident-To By Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC | March 7th, 2024 | There is always confusion in appropriate roles and billing for non-physician practitioners (NPPs) such as nurse practitioners and physician assistants. Non-physician practitioner is the term CMS uses for these individuals, while other payers […]
March Brings with it National Kidney Month
March Brings with it National Kidney Month By Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer – March 4, 2024 The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health (OMH) has announced that March is National Kidney Month. Chronic kidney disease (CKD) affects 14 percent of adults in the United […]
Coding and Denials: It Comes Down to ‘ABCD’
Coding and Denials: It Comes Down to ‘ABCD’ By Angela Lima BS, CCS, CDIP, CIC, COC, AAPC-Approved Instructor | February 5th, 2024 | If you oversee the coding process or directly manage coders, you know how important accurate, defensible coding is. Inaccurate coding leads to claim denials. An increase in claim denials may lead to […]
CPT Coding: Unlisted CPT Codes Are Not a Sign of Laziness
CPT Coding: Unlisted CPT Codes Are Not a Sign of Laziness By Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC|February 29th, 2024 When a coding professional assigns an unlisted code, or a physician advises the use of an unlisted code, it does not mean that the coder is too lazy to work to find […]