In a concerted effort to move healthcare payments to a system of "quality over quantity," CMS finalized policies that greatly expanded packaging for outpatient providers in the 2015 OPPS final rule (www.gpo.gov/fdsys/pkg/FR-2014-11-10/pdf/2014-26146.pdf). It also introduced complexity adjustments with comprehensive ambulatory payment classifications (C-APCs).
The ICD-10 delay forced many healthcare organizations to rethink their ICD-10 staffing and implementation plans. Baptist Health System in Birmingham, Alabama, devised a plan to prepare for the one-year delay of ICD-10 by revising its budget and relying on new graduates to fill coder positions.
Beginning January 1, 2015, physicians will no longer need to provide certification for an inpatient admission unless the admission is expected to last for at least 20 days or the case is an outlier.
Coding for sepsis requires a strong knowledge of ICD-9-CM coding guidelines, as well as complete and accurate documentation. That's not a surprise to any coding professional. They need those two elements to successfully code any medical record.
While it can be challenging to define your organization's legal health record (LHR), one health system in Denver is proving that collaboration and perseverance can lead to an effective LHR and EHR.