Increased ED volumes, changes in regulatory requirements, the required use of observation, and added scrutiny from the recovery audit contractors have made implementing an ED case management model essential.
Recruiting, retention, and turnover are challenging in any profession. Case management is no exception. Experienced, competent case managers are especially hard to find, says Wendy De Vreugd, RB, BSN, PHN, FNP, senior director of case management for West Region at Kindred Healthcare, Hospital Division, in Westminster, CA.
As physicians, we are quite aware of the severity of illness of the cancer patients we treat. However, we frequently are not cognizant of the elements of their diseases that need documentation or clarification in the medical record to accurately portray the complexity of those patients. I’d like to discuss some of the issues that surgeons, oncologists, family physicians, and pediatricians might face that need some attention in documentation.
The transition to ICD-10 is not in any way the kind of transition we made from ICD-8 to ICD-9, nor is it a simple matter of training coders and implementing a revised encoding system. This will probably be one of the biggest transitions hospitals and HIM directors and coders have seen in many years.