Educating coders and clinical documentation improvement (CDI) specialists on CMS claims-based measures is essential in today's value-based payment environment. Empowered with an understanding of measure specifications and risk adjustment methodologies, a strong CDI program can effectively address opportunities to improve quality profiles and associated hospital revenue.
In the first article in this series, we provided an introduction and overview of the PSI 90 measure, which is included in two CMS pay-for-performance programs. Because PSI 90 is a claims-based measure, performance is largely determined by ICD-9-CM codes on the claims.
Throughout the years, this column has focused on the important role the electronic document management system (EDMS) plays as the official legal health record (LHR) within a healthcare organization, and especially as a critical workflow tool for the HIM department. I am always surprised to hear that there are still some facilities that haven't figured this out and purchased an EDMS.
It has been a long time since The Joint Commission has published frequently asked questions (FAQ), which serve as a great resource for clarification of standards and elements of performance. Generally, FAQs originate with questions from the field that continue to be asked over time.
It's a prevailing trend?HIM directors and managers are overworked and underpaid. The results of MRB's 2015 HIM director and manager salary survey shows this trend remains firmly in place, although it does indicate these professionals' annual earnings have seen a slight uptick.