While some HIM professionals may feel a sense of relief knowing RAC audits are on hold for the remainder of 2015, that should not deter workforce members from keeping track of denials and appeals and defending code assignments.
As the industry approaches ICD-10 implementation, end-to-end testing becomes more critical. Testing allows organizations to determine the efficacy of their preparations. It also answers critical questions for ICD-10 stakeholders: Can applications accommodate ICD-10 codes correctly? Does data flow seamlessly between internal and external interfaces? Are payers able to receive, adjudicate, and pay claims correctly?
In the first article in this series, we provided an introduction and overview of the PSI 90 measure, which is included in two CMS pay-for-performance programs. Because PSI 90 is a claims-based measure, performance is largely determined by ICD-9-CM codes on the claims.
