The 3-day payment rule is known to coders by various names such as the 72-hour rule, the 3-day payment window, or MS-DRG window policy. Kimberly Lee M.Ed., RHIA, CCS-P, describes how to navigate the rule’s nuances for billing purposes.
Every organization’s priorities will differ, but any outpatient CDI program must determine how to measure the improvement associated with its efforts. Outpatient CDI will directly contribute to the facility’s overall quality performance and risk adjustment models.
The 2023 CPT update will shift provider consults, facility, and home-based E/M visits to a coding model based on medical decision-making (MDM) or time, according to the AMA.
JayHodes, president of HIPAA compliance company Colington Consulting in Burke, Virginia, sees eight specific challenges organizations face when trying to comply with HIPAA regulations.
Coding managers should not assume that they can review every coding guideline, Coding Clinic, or coding-related issue targeted by the Office of Inspector General. Review considerations for conducting focused internal and external audits.
