Editor's note: The following scenario is provided by Laurie A. Rinehart-Thompson, JD, RHIA, CHP, assistant professor of clinical allied medicine in the School of Allied Medical Professions at Ohio State University in Columbus. Present the scenario portion to your HIM staff to see how they would handle the issue.
Coders need to code. This much you know. But with the transition to ICD-10-CM/PCS occurring perhaps as soon as October 1, 2014, they'll need to know a bit more than just raw coding. Now is a good time to review and update current coding descriptions, procedures, and job titles to streamline and reengineer your coding team's work flow, says Luisa DiIeso, RHIA, MS, CCS.
Coding accuracy in postoperative complications impacts a facility's Medicare claims profile, error rate, and physician profiles on hospital watchdog websites that monitor performance.
Retain. Train. Assess. Investigate. Analyze. HIM professionals have undoubtedly come across action verbs like these since HHS announced on January 15, 2009, the final regulation to replace the ICD-9-CM code set with the more advanced ICD-10-CM code set currently used in other nations.
It's September-time to hit the books again and get back to school. If you're an aspiring HIM professional, that means learning about medical record retention.
Over the last six months, The Joint Commission's survey have continued to show a pattern in regard to findings related to the Record of Care and Treatment chapter of the Joint Commission accreditation manual. The challenging standards are outlined below, including tips for compliance.
Betty B. Bibbins has a message for any healthcare professional-including HIM managers and directors-who struggles to get physicians to document with enough specificity to produce compliant coding and billing: It's your job to tell them how to do it better.
