Uncommon MS-DRGs can be a red flag to auditors even when the encounter is correctly assigned to one. Use these tips to ensure coding and documentation supports the use of these MS-DRGs.
CMS developed the National Correct Coding Initiative (NCCI) to control improper coding and potentially inappropriate payment of Part B services. Review NCCI basics to ensure compliance with the latest coding policies.
Clinical validity denials occur when there is a lack of clinical evidence in the patient chart to support a billed diagnosis. Learn more about common reasons for these denials and how to defend against them.
