Editor's note: The following scenario is provided by Laurie A. Rinehart-Thompson, JD, RHIA, CHP, assistant professor of clinical allied medicine in the School of Allied Medical Professions at Ohio State University in Columbus. Present the scenario portion to your HIM staff to see how they would handle the issue.
Coders need to code. This much you know. But with the transition to ICD-10-CM/PCS occurring perhaps as soon as October 1, 2014, they'll need to know a bit more than just raw coding. Now is a good time to review and update current coding descriptions, procedures, and job titles to streamline and reengineer your coding team's work flow, says Luisa DiIeso, RHIA, MS, CCS.
Coding accuracy in postoperative complications impacts a facility's Medicare claims profile, error rate, and physician profiles on hospital watchdog websites that monitor performance.
Paula Moran, MEd, and Jennifer Edlind, JD, CHC, know what they're talking about when they say having an incident response team in place when a data breach occurs is important. Moran is privacy and security manager at Massachusetts General Hospital (MGH) in Boston. Edlind is director of privacy and compliance operations at University Hospitals Health System (UH) in Cleveland.
When the AMA revised the instructions for reporting ancillary services with critical care in 2011, facilities knew they wouldn't see an immediate increase in payment. CMS determines payment amounts through use of claims data from two years earlier, meaning the earliest facilities could expect additional reimbursement is 2013.
