Internal Auditing

Back to the Basics: How to Do an Internal Coding Audit

MRA Coding 1 Comment

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, and increase communication across the organization. Not only do they …

Auditing

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

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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. Knowing these …

House of Cards Risk

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

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  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 …

Due Diligence: 2 Ways Outsourcing Medical Coding Helps Your Hospital

MRA Coding, Outsourcing 3 Comments

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 need to …

ICD-10-PCS Coding For Venous Access Lines and Catheters

C. Matheson Coding, Outsourcing 6 Comments

One challenging coding area with the ICD-10 transition is the coding of venous and arterial lines and catheters. This article aims to provide greater clarity with regard to procedure coding tips for coding of venous catheters. Types of Lines: Central Lines– (CVC)- Central Venous Catheter or central lines are inserted into large veins, typically the jugular, subclavian, or femoral vein. …

Know How To Code Complications Of The Flu During This Peak Season

Cathie Wilde Coding 4 Comments

Flu During Peak Season It’s that time of year again—flu season. According to data from the Centers for Disease Control and Prevention (CDC), 43 states are experiencing high or widespread flu activity mostly due to the spread of the H3N2 virus. For the week ending December 27, 2014, visits for influenza-like illness accounted for 5.9% of all clinic visits. During …

Coders, Use Those Resources

Cathie Wilde Coding 1 Comment

In today’s electronic world, coders have a variety of technology tools to make their jobs easier. These applications boost coder productivity while also improving code quality and accuracy. With the inevitable implementation of ICD-10, the reliance on coding technology will become even more prevalent—and important. Here are key coding resources every coder should be aware of and have readily available …

Changing Roles for Coding Professionals

Lynn S Coding Leave a Comment

Role changes are on the horizon for coding professionals. With the implementation of Computer Assisted Coding (CAC), ICD-10 and Hospital Value-based Purchasing (HVBP), clinical coding will take on different forms and new responsibilities. Traditional coding careers may transition to auditors, data analysts or even clinical documentation improvement / integrity specialists (CDIS). Coders → Auditors Coders morph into auditors when CAC …