Don’t be in Denial about Denials

C. Matheson 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 inundated with payer …

Matters of the Heart: FY2018 Code Changes Impacting Heart Failure

C. Matheson CDI, Coding 2 Comments

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 …

What’s the Skinny on Obesity and BMI Coding??

C. Matheson CDI, Coding Leave a Comment

Overweight and obesity are increasingly common conditions in the U.S. They are caused by the increase in the size and amount of fat cells in the body. Doctors measure body mass index (BMI) and waist circumference to screen and diagnose overweight and obesity. The National Institute of Health has deemed obesity as a serious medical condition that can cause complications …

What do all those radiation treatment modality codes mean?

Kerri Helms Cancer Registry, Coding Leave a Comment

The regional treatment modality fields for radiation therapy can be tricky when deciding on the appropriate code to assign. The regional treatment modality field is used to record the dominant modality of radiation therapy used to deliver the most clinically significant regional dose to the primary volume of interest during the first course of treatment. Codes are assigned to evaluate …

The Privacy Mindset with Third Party Record Reviewers

Amy Derlink Careers, CDI, Coding, Disclosure Management, Outsourcing Leave a Comment

As HIM professionals we expect others we encounter in our personal and professional lives to share our same high level of commitment and dedication to our professional career.  We also expect that from our team at the office, including external third-party auditors and record reviewers. External reviewers must share your organization’s commitment to protecting patient privacy and keeping medical records …

Documentation Management in Support of the Electronic Health Record

Laureen Rimmer Coding, Leadership, Outsourcing Leave a Comment

Electronic Health Records (EHRs) continue to change the landscape of healthcare.  Although the technology and workflow of electronic documentation seems to make paper documents obsolete, a hybrid medical record exists in many healthcare settings.  Organizations need to determine which paper documents to include with the EHR, access to that documentation and when to include that information when releasing protected health …

ROOT OPERATION DILEMMA: CONTROL vs. DESTRUCTION

Cathie W CDI, Coding, Disclosure Management, Outsourcing 1 Comment

A 67 year old male who had been experiencing frequent melena presents to the hospital for work up and treatment. An esophagogastoduodenoscopy (EGD) was performed with the finding of a medium sized angioectasia (AVM) seen in the mid jejunum which was thought to be the source of the bleeding.  As a result, the following procedure was performed: A single medium …

2017 HIM Challenges in Data Integrity, Revenue Integrity & Denial Prevention

Laureen Rimmer CDI, Coding, Disclosure Management Leave a Comment

As we evolve in 2017, the challenges have settled for Health Information Management (HIM) post implementation of ICD-10.  Clinical Documentation Improvement (CDI) programs and Computer Assisted Coding (CAC) continue to bring value to data integrity.  Larger healthcare systems continue to centralize revenue services while their auditing efforts have improved with technology and resources to conduct audits, analyze findings and implement …

Insight into Coding Diabetic Eye Conditions

C. Matheson CDI, Coding, Leadership, Outsourcing Leave a Comment

  There are a variety of conditions that can impact individuals with diabetes.  People with diabetes are at greater risk for developing eye problems that could lead to blindness or serious deterioration of sight.  Age also plays a role in the progression of eye disease in individuals with diabetes.  Cataracts, glaucoma and retinopathy are the most common eye diseases that …