HIApro assists healthcare providers by performing coding, billing, documentation compliance reviews and education. Our comprehensive service will discover trends that may adversely affect quality scores, identify high risk areas prone to payor audits, help reduce claims denials and ensure appropriate reimbursement.
The number of physicians employed by health systems continues to rise. This growth will bring increased financial and compliance related risks. As the industry moves towards a value-based payment model, quality metrics and costs will dictate reimbursement. Additionally, government and commercial payors are poised to scrutinize claims more aggressively. The need for qualified professional coders has never been greater.
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Part 5: Reasons for AKI Denials and Prevention | AKI Series
Why are so many AKI records being denied? It’s hard to give one answer for why so many AKI records are being denied lately, but most appear to be due to the multiple sets of criteria available for use in determining if a patient has AKI, as well as physician documentation. As stated in Part 3 of this series, there are three main criteria/classifications used to diagnose AKI.
Part 4: Is Documentation Present to Report Acute Kidney Injury/Failure? | AKI Series
In previous parts of this series we looked at the definitions of AKI/ARF, causes, coding and sequencing, and the common clinical indicators that patients present with that are diagnosed with this condition. In Part 4, we will look at the documentation that should be present to report the diagnosis without fear of denial, as well as when a query is needed to clarify the diagnosis.
Coding Tip: Z Code Reporting for COVID-19
If the facility does a COVID-19 test, and test is negative, do I need a diagnosis code. The answer is yes, you will report a Z-code. The Z-code depends on the record documentation and circumstances of testing. For any patient receiving a COVID-19 test, if negative, there MUST e a Z-code to describe why the test was taken. (Test negative for COVID-19 and MD does not override negative results).
Part 3: Clinical Indicators for Acute Kidney Injury/Failure | AKI Series
In the first parts of this series we looked at definitions of AKI/ARF, causes, coding and sequencing. In Part 3, we will look at what clinical indicators would possibly be present to support the diagnosis of AKI/ARF.
FY2021 Proposed Rule and Code Changes Highlights
The FY2021 IPPS Proposed Rule is out and here are some highlights from it regarding ICD-10 Code proposals. We will know if these changes are permanent after the public comment period is over on July 10, 2020 and CMS prepares the Final Rule, usually out by August 1.
HIApro Reports
HIA delivers comprehensive electronic daily and month-end reporting to its clients. The content and format of these reports promote transparency and allow for easy invoice reconciliation.
HIApro Reports
HIA delivers comprehensive electronic daily and month-end reporting to its clients. The content and format of these reports promote transparency and allow for easy invoice reconciliation.
