Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
The 2018 update to the ICD-10-CM code set went into effect October 1, 2017, and features 728 total code changes, including 360 new, 142 deleted, and 226 revised codes.
In recent years, the U.S. healthcare system has begun a shift from a volume-based to a value-based system, causing the role of many case managers to evolve. So what does this role look like, and how can your organization get there?
