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Exceptional Coders | Innovative Technology

Hospitals Now Allowed to Use Non-Physician Documentation to Support Coding for Social Determinants of Health

Posted by David Fong on Jul 26, 2018 7:00:00 AM

A recent Becker’ Hospital CFO Report  article noted the changing of the rules governing reporting of social determinants of health following the American Hospital Association's diligent work. The association said the ICD-10-CM Cooperating Parties, including AHIMA, AHA, CMS and the National Center for Health Statistics, approved advice published by the AHA Coding Clinic that allows hospitals to report ICD-10-CM codes included in categories Z55-Z65, based on documentation from all involved caregivers, including non-physicians. That change took effect in February of this year.


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Topics: Medical Coding, Clinical Documentation, Outsourcing

The FY2019 ICD-10-CM Code Changes Have Been Released – Are YOU Prepared?

Posted by David Fong on Jul 13, 2018 6:00:00 AM

The Centers for Disease Control and Prevention (CDC) released the fiscal year (FY) 2019 ICD-10-CM (diagnosis) code changes last month. There are 473 code changes beginning October 1, 2018. They include 279 new codes, 143 revised codes, and 51 deactivated codes, according to the CDC website. In addition, there were 39 additional changes added from the proposed rule (list). The ability to code properly to these new and revised codes starting October 1 can make the difference in getting clean claim and being paid quickly or needless reimbursement delays.


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Topics: Medical Coding, Clinical Documentation, Outsourcing

Outsourced Clinical Documentation Functions Enhance Patient Care and Healthcare Revenue

Posted by David Fong on Jun 21, 2018 7:30:00 AM

Clinical documentation improvement (CDI) ensures that health services are accurately documented and helps healthcare coders and physicians work toward improved patient care, while also streamlining productivity. When meaningful clinical data is captured, organizations can ensure improved quality reporting, clinician productivity, and even better – accurate clinical information is delivered at the point of care.

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Topics: Medical Coding, Clinical Documentation, Outsourcing

The Rising Costs of Healthcare Billing

Posted by David Fong on May 8, 2018 6:00:00 AM

A recent study reported in a Los Angeles Times article found that healthcare in the United States is very expensive. One of the contributing reasons is that managing healthcare bills is really expensive. How expensive? At one large academic medical center, the cost of collecting payments for a single primary care doctor is upward of $99,000 a year.


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Topics: Medical Coding, Clinical Documentation, Outsourcing, Coding Denial Management

Accurate Coding and Documentation Are Critical in Today’s Value-Based Care Environment

Posted by David Fong on Apr 24, 2018 6:00:00 AM

At the American College of Cardiology’s Cardiovascular Summit in February, one presenter's PowerPoint slide showed how much proper documentation and coding could affect a hospital’s quality measures and bottom line.

 

Reported in Cardiovascular News, Linda Gates-Striby used a hypothetical example of a 76-year-old woman with diabetes and heart failure. If clinicians only documented basic information about this patient, her expected cost of care per month would be in the ballpark of $5,000. But by coding more specific designations for the diabetes and heart failure—and noting an interaction between the conditions—the total risk score value would balloon to $13,554 per month.

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Topics: Medical Coding, Clinical Documentation, Outsourcing

Healthcare Executives Survey Cites Cost Transformation Need as Revenue Cycle Management Improvement Has Jumped to Top Hospital Priority

Posted by David Fong on Feb 8, 2018 6:00:00 AM

A recent Kaufman Hall survey found that an overwhelming majority of healthcare executives (96 percent) stated that cost transformation is a significant need for their hospital or health system. Yet, over 50 percent of organizations surveyed either do not have a healthcare cost reduction goal or have such a small goal that it will not, in reality, transform their cost structures.

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Topics: Medical Coding, HIM, Clinical Documentation, Denial Management

Stop Challenges Before They Happen with a Comprehensive Accuracy Review of Coding-Related Practices

Posted by David Fong on Jan 24, 2018 10:30:00 AM

A recent Becker’s Hospital Review article stated that Catholic Health had agreed to pay $6M to settle overbilling allegations. A nursing home subsidiary of the health system allegedly submitted claims to Medicare for the highest and most expensive levels of therapy when that type of therapy was not medically necessary or was unsupported by medical records. The allegations against Catholic Health were originally brought by a whistle-blower under the qui tam provision of the False Claims Act.

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Topics: HIM, Clinical Documentation, Coding Compliance, Medical Coding Audits

Revenue Cycle Management Expected to Grow 11% Annually

Posted by David Fong on Jan 11, 2018 7:00:00 AM

The medical sector has been undergoing a series of interminable changes over the last few years. In consequence, healthcare revenue cycle management (RCM) market is set to witness a marked growth because of the rising need for timely bill reimbursements and insurance claims. Increased complexity in the medical coding process has led to the necessity of RCM solutions that help reduce billing errors.

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Topics: Medical Coding, HIM, Clinical Documentation, Denial Management, Coding Compliance, Medical Coding Audits

Aviacode Joins AHIMA’s CDI Month Celebration

Posted by David Fong on Jul 5, 2017 10:30:00 AM

Not only is clinical documentation improvement (CDI) the key to better ICD-10 coding and reimbursement accuracy, but it's also vital for preparing healthcare organizations for the new care paradigm of population health management. To this end, AHIMA has designated the month of July as CDI Month with Aviacode joining in the recognition to CDI professionals nationwide.

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Topics: Revenue Cycle Management, Medical Coding, Clinical Documentation

Hey Doc, ICD-10 Affects You Too!

Posted by Danny O'Very on Sep 24, 2015 9:37:16 AM


Do you recall the year 1999, or as it became known "Y2K"? People were nervous, scared, and a little irrational with their fears towards the turn of the millennium. I have often reflected back on 1999 as I participate in conversations surrounding the October 1st ICD-10 deadline.

 

The fears that people have expressed have been, well...somewhat irrational. For the most part, healthcare professionals have created an ICD-10 readiness plan. The eBook "The Definitive Guide to ICD-10" has helped many nationwide develop and implement or even reinforce their current ICD-10 transition plan. The supplemental "12 step guide infographic" has attempted to break the plan down into bite size chunks for healthcare professionals. Most of the healthcare professionals we speak with today have a solid plan. Most have reconfigured their systems to support the new requirements. Their IT transition appears to be on point. Many organizations have either already certified their own coders in ICD-10 or they have taken steps to outsource their medical coding to companies like Aviacode who have access to thousands of certified ICD-10 coders. Most, if not all, have set aside budget to accommodate some of the “unknowns” as we approach the ICD-10 deadline. So, is there really any reason to reach for the panic button?

 

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Topics: ICD-10, Physicians, Clinical Documentation