HIM Briefings

Although there are basic expectations of a utilization review (UR) team member, organizations should develop performance expectations and competencies for their UR staff based on their own needs. Use this sample UR specialist job description as a template for your organization.

ICD-10-CM codes for traumatic fractures specify the type of bone injury, affected area of the body, and in some cases, the degree of soft tissue damage. Refresh your knowledge of terminology and documentation requirements to ensure accurate coding.

When looking into the general overview of a CDI specialist’s responsibilities, it is important for new specialists to understand the basics of coding, querying, and physician education. Use these strategies to brush up on the CDI essentials.

Modifier -58 describes a staged or related procedure or service by the same provider during the postoperative period. Apply these experts tips to ensure it's used correctly.

Ongoing labor shortages and a competitive hiring market are putting a strain on HIM departments. As competition for qualified staff increases, learn how HIM leaders can turn to a variety of short- and long-term fixes and even find opportunities for improvement.

Risk adjusted payment methodologies in outpatient settings call for a different CDI approach. Learn how one organization conducts risk adjustment outpatient CDI reviews to support correct coding and documentation.

Tracking denials data as a key performance indicator (KPI) can help identify gaps in provider documentation and create meaningful physician education. Learn how to leverage coding and CDI staff in tracking and managing denials data.

Although many provisions of the 2022 Outpatient Prospective Payment System (OPPS) final rule are a light lift for hospitals, several have far-reaching implications. Apply these expert tips to ensure you're up to speed and aware of compliance pitfalls.