The Joint Commission continues to provide excellent resources to help healthcare organizations stay ready for surveys, as well as resources that help them meet and understand the intent of standards and elements of performance.
In ICD-10-CM, defining, diagnosing, and documenting the various forms of altered mental status and their underlying causes remains an ongoing challenge for physicians and their facilities.
Ochsner Clinic Foundation began its ambulatory clinical documentation excellence journey in 2004, when Medicare implemented its Hierarchical Condition Categories (HCC). Since HCCs affect patients’ Risk Adjustment Factor scores, and ultimately reimbursement for the care required to treat sicker patients, Ochsner needed to determine the best way to ensure annual HCC capture for all patients across its vast system.
When CMS introduced Hierarchical Condition Categories (HCC) with risk-adjusted scores, Ochsner Health System began efforts to educate providers and improve documentation across its many facilities.
Kidney disease is a challenging component to inpatient and outpatient care, incurring significant costs and negative outcomes. CMS and other agencies that measure our quality and cost efficiency use ICD-10-CM codes based on provider documentation and billing to ascertain that a patient has a designated kidney anatomic or functional illness in their risk-adjustment methodologies.
When it comes to dealing with Medicare Recovery Auditors (RACs), there is never a dull moment for HIM professionals. Any shift in the RAC program quickly emerges as front-page news for HIM leaders.
