Coders are now tasked with reporting social determinants of health, or circumstances in patients’ lives that can influence the quality of their life and overall wellbeing. Understand how to improve documentation of these factors and ensure complete and accurate coding.
As CDI programs are created or renewed, the main focus tends to be on the CDI department structure: its policies, education, staffing needs, and key performance indicators (KPI). Hone your understanding of appropriate CDI KPIs.
Defining the line between a coder comprehending the record’s meaning and interpreting documentation can be a challenge. Consider these ways to improve documentation and foster critical thinking in coders.
There are many things that can go awry during gestation resulting in a neonate with temporary or permanent health conditions. Physicians have found ways to treat many congenital defects in utero, enabling the neonate to be born without defects. Review coding guidelines for fetal surgeries.
Organizations must ensure their procedures are aimed at preventing and managing denials. One way to accomplish this is by looking for opportunities to involve other departments. Use these tips to improve interdepartmental denials management.
Analyzing data that comes from claim scrubber edits, return to provider edits, variances, and denials can provide insight into repetitive issues that delay the processing of a claim or lead to denials. Use these tips to improve your organization's pre-billing analysis processes.
Regular charge reconciliation is a cornerstone of complete, compliant reimbursement but is a common weak point for hospitals. Apply these tips to support clinical staff responsible for charge reconciliation and improve charge capture.
CMS recently revised the evaluation and management (E/M) coding guidelines for inpatient providers. Understand the far-reaching effects of the changes and how to ensure your organization is in compliance.
