Electronic health records fall short of early promises that they would reduce administrative costs, a recent study found. The cost of completing insurance- and billing-related activities in the EHR can represent more than a quarter of professional reimbursement for an emergency department visit.
The implementation of an EHR is a multifaceted, comprehensive project for healthcare organizations. To avoid coding issues during EHR implementation and ensure discharged-not-final-coded is not adversely impacted, dedicated HIM focus and detailed project planning are paramount.
Organizations and CDI specialists must have a thorough understanding of how regulations and guidelines impact risk adjustment in the outpatient setting. A misinterpretation can easily lead to inadvertent upcoding—and that can lead to costly audits, settlements, and accusations of fraud.
In May, we expect to see the release of the International Classification of Diseases, 11th Edition, for Mortality and Morbidity Statistics (ICD-11-MMS) by the World Health Organization. Work will then begin in the U.S. to adapt it for our clinical use as ICD-11-CM. Hopefully, with the benefit of foresight and lessons learned from the past, we will not reenact the pain we all had with the ICD-10-CM/PCS implementation.
