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Coding Review

Client X: Let’s Talk Numbers

Client X: Let’s Talk Numbers

A higher CMI corresponds to increased consumption of resources and increased cost of patient care, resulting in increased reimbursement to the facility from government and private payers, like CMS. We know that documentation directly impacts coding.

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Part 1: Top 3 CM Chapters 2019 from ProFee Reviews

Part 1: Top 3 CM Chapters 2019 from ProFee Reviews

In 2019, we reviewed over 50,000 diagnosis codes from many different specialties for our Professional Fee clients. Here are the top three ICD-10-CM chapters where HIA identified coding opportunities: Z00-Z99 – Factors influencing health status and contact with health services; I00-I99 – Circulatory system and; R00-R99 – Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified.

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OIG Takes Notice of Coding Errors

OIG Takes Notice of Coding Errors

Back in April, the Office of the Inspector General (OIG) published a report detailing its findings from a review of two groups of high-risk diagnosis codes, acute stroke and major depressive disorder. The objective was to determine whether selected diagnosis codes submitted to the Centers for Medicare and Medicaid Services for use in CMS’s risk adjustment program complied with Federal requirements.

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It Only Takes One Code

It Only Takes One Code

How many times have you heard “it only takes one code to get the claim paid”? With the emphasis on the severity of illness and the move toward value-based reimbursement in today’s healthcare climate, it is more important than ever for coders to report all applicable diagnoses. There are three important pieces: what the provider documents, how to the coder interprets that documentation and codes it, and then how it is extrapolated.

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