Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.
Q: We have a patient who received a pancreas transplant for the treatment of diabetes. The patient was later admitted to the hospital for treatment of an unrelated kidney stone. Would I still need to assign the ICD-10-CM code for diabetes as a chronic condition based on the patient’s medical history?
This week's note from the instructor looks at the progress CMS has made in reducing burden through the Patients over Paperwork initiative and explores potential topics for providers to comment on to drive additional improvement.
Q: I work for a behavioral health recovery center, and many of our programs fall under 42 CFR Part 2, as we provide substance use services. Sometimes a referring agency follows up to ask if a client has scheduled an appointment. Can we confirm that a patient has made an appointment? Do referral appointments like this fall under PHI?
Inpatient rehabilitation facility documentation compliance is coming under scrutiny. Learn how you can improve processes, strengthen compliance, and avoid costly audits.
