COVID-19 Related Coding Audits How Audits in the time of COVID are effecting healthcare institutions. In healthcare, audits, no matter how unpleasant they are, come with the territory. However, with the advent of the COVID-19 outbreak, audits have taken on a whole new level of dreadfulness. Read on to explore subjects related to the combination of Medicare’s medical...

5 Tips to Provide Effective Post-Audit Education You’ve identified high-risk areas based on previous audits or the OIG Work Plan. Or perhaps you decided to audit new service lines or high-dollar as well as high-volume procedures. You’ve selected a random sample of claims. You’ve audited those claims to determine coding and documentation accuracy. Now what? It’s time to...

Internal coding audits are an important tool in any hospital’s compliance program. They illuminate potential areas for corrections prior to scrutiny by payers and regulators, which can help reduce payer denials and protect revenue. Additionally, performing regular, ongoing internal auditing can improve clinical documentation and coding initiatives, enhance data integrity,...

By: Carrie Pfeifle, BS, RHIT | Coding Audit Manager @ MRA Transcatheter Aortic Valve Replacement (TAVR) is also known as Transcatheter Aortic Valve Implantation (TAVI). Medicare officially refers to this as TAVR/TAVI, but either single acronym is correct. TAVR is a transcatheter surgical procedure in which an aortic valve replacement is performed without removing the...

Internal coding audits are an important tool in any hospital’s compliance program. They illuminate potential areas for corrections prior to scrutiny by payers and regulators, which can help reduce payer denials and protect revenue. Additionally, performing regular, ongoing internal auditing can improve clinical documentation and coding initiatives, enhance data...

Simply mentioning a coding audit sends a shiver up a coder’s spine. The thought of scrutinizing their coding quality, as they strive to balance quality and productivity, can bring dread to even the most seasoned coder. But conducting internal or external coding audits are an important part of ensuring quality and regulatory compliance for hospitals and health systems....

March is kidney cancer awareness month. So what is the role of our kidneys? The kidneys are bean shaped organs located on each side of the mid back. The kidneys are retroperitoneal organs that lie behind the peritoneum that lines the abdominal cavity. The main function of the kidneys are to filter the blood and get rid of excess water and waste in the urine. However, did...

The following Latin proverb seems to be particularly relevant in light of ICD-10: “Times change, and we change with them.” By now, ICD-10 has spurred many changes in technology, templates, coding, documentation, and more. However, to be truly successful, organizations must look beyond their HIM internal processes and ask this question: Must the organization’s relationship...

Although CDI programs have typically been implemented in the inpatient setting, many organizations are beginning to turn their attention toward outpatient documentation as well. That’s because many of the same documentation deficiencies occur in both settings. Poor outpatient documentation—particularly in the emergency department (ED) record—can also affect inpatient code...

How to Successfully Navigate Appeals Even with the temporary suspension of RAC reviews, hospitals continue to deal with insurance denials from a multitude of third party payers. Cathie Wilde, CCS Vice President of Coding Responding to these coding denials is time consuming. HIM, revenue cycle and coding professionals are further frustrated when they believe their...