A coding audit may be conducted by internal staff or external entities, typically representing the insurers paying for the care. When planning to implement a coding auditing program, the type of reviews, focus areas, and review frequency must all be taken into consideration.
With new attention on the care continuum, many new roles are being created to both complement the comprehensive needs of patients and ensure that licensed individuals have the opportunity to work at the top of their license.
CMS recently released MLN Matters SE18001 to provide healthcare practitioners with instructions and coding guidance for specimen validity when performed and billed in combination with drug testing. The article was issued to remind laboratories and other providers performing urine drug testing that specimen validity testing (SVT) is not separately billable.
Much of the population health model is relatively new. Some of the work is based on other models, particularly the public health model. We know how important an efficient case management structure is to the success of the population health model. How does an organization not only change the model of case management but sustain the change and continue to evaluate its success?
