8 Facts To Get Your Team Ready For a Successful Coding Audit

C. Matheson, RHIA, CCS Auditing Leave a Comment

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....

Why Pro-Fee Coding Is the Next Great Risk to Your Revenue

C. Matheson, RHIA, CCS Profee Coding Leave a Comment

  As we discussed last week, over the past decade, there has been a tremendous amount of consolidation in healthcare. For hospital-owned physician practices specifically, we have seen the number  rise from 35,700 in July 2012 to 80,000 in January 2018. Over the same period, there was over a 70 percent increase in the number of physicians employed by hospitals or health...

Due Diligence: 2 Ways Outsourcing Medical Coding Helps Your Hospital

C. Matheson, RHIA, CCS Outsourcing Leave a Comment

One of the key trends to emerge from last month’s JP Morgan Healthcare Conference was the shifting mindsets of hospitals. For the last decade, hospitals have had a defensive mindset; acquiring or merging with smaller hospitals and physician practices to outpace their competitors and grow top line revenue. But to receive the full payoff of this consolidation, hospitals...

Best Practices for Coding Audits: Recommendations, Best Practices, and Common Pitfalls

Charlie Saponaro - CEO Medical Coding Leave a Comment

In coding, like most every other area of life, there is not one solution for every organization’s potential problems. Coding is an ever-expanding area of focus for most every healthcare organization, and nearly every health system and the facility has or is making substantial investments in coding staffs and making these departments more robust. There are hurdles and...

Preparing For the Upcoming Cancer Registry Changes: Time Is Short, but Support is Available

Susan Mackenzie Cancer Registry 1 Comment

Preparing For the Upcoming Cancer Registry Changes: Time Is Short, but Support is Available By Susan Mackenzie, MRA For those of us working in the cancer registry profession, you are likely very much aware of the significant changes upon us that will dramatically alter the way we work and how we collect required data for the registry. The upcoming changes are extensive,...

Back To Basics - Section III. Reporting Additional Diagnoses

Cathie Wilde, RHIA, CCS - Director, Coding Services Medical Coding Leave a Comment

One of the more prominent guidelines found in the ICD-10-CM Official Guidelines for Coding and Reporting is Section III. Reporting Additional Diagnoses but it isn’t always applied appropriately. The guideline states: For reporting purposes the definition for “other diagnoses” is interpreted as additional conditions that affect patient care in terms of requiring: clinical...

E/M Leveling: Compliance, Correct Coding and Best Practices

C. Matheson, RHIA, CCS Medical Coding 1 Comment

Recently, we’ve had a number of conversations with healthcare leaders concerned about their evaluation and management (E/M) coding levels being out of synch with Centers for Medicare and Medicaid Services (CMS) guidelines, and who wanted to review their processes to ensure compliance. Concerns over whether coding departments (if not outsourced) are properly notating the...

Understanding the Difference: Swan-Ganz Catheterization vs. Right Heart Catheterization

Cathie Wilde, RHIA, CCS - Director, Coding Services Outsourcing Leave a Comment

Let’s first look at what a Swan-Ganz catheterization is and how the procedure is performed. The Swan-Ganz catheter is synonymous with a pulmonary artery catheterization. It was named in honor of its inventors who were Jeremy Swan and William Ganz from Cedars-Sinai Medical Center in 1970. It is a flow-directed catheter with a balloon tip that is inserted via an internal...

Don't be in Denial about Denials

C. Matheson, RHIA, CCS Medical Coding Leave a Comment

The pace of change, consolidation, and ever-increasing pressure on revenue and financial stability in the healthcare industry is enough to make our heads spin on a daily basis.  Couple that with the onslaught of government and commercial payer audits and denials, it’s no wonder healthcare organizations are in denial about the state their denials.  Feeling overwhelmed and...

Matters of the Heart: FY2018 Code Changes Impacting Heart Failure

C. Matheson, RHIA, CCS CDI Leave a Comment

Heart failure is a serious medical condition that an estimated 5.7 million Americans are diagnosed with.  This is a condition that occurs when the heart muscle cannot pump enough blood and oxygen needed by the body to support the other organs.  According to the Center for Disease Control, the national estimated cost to treat heart failure is nearly $31 billion each year. ...

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