Hierarchical Condition Categories and Risk Adjustment by David Reece, BSN, RN, CCDS, Consulting Director, Outpatient CDI Solutions, MedPartners University If you’ve been following the trends of healthcare, it seems that hierarchical condition categories (HCCs) are the buzzword in outpatient.
Standardizing Audit Feedback to Enhance the Outpatient Educational Process Lynn Thornton, RHIA, CCS MedPartners Education and Compliance Manager There is no doubt the auditing process is a valuable endeavor that helps drive correct coding, optimize reimbursement and satisfy coding compliance efforts.
How to Validate a Diagnosis of Acute Respiratory Failure The Power of the P/F Ratio One of the most important pieces of clinical evidence that assists in validating a diagnosis of acute respiratory failure is the P/F ratio.
NCCI Edit Resolution In Three Easy Steps Lynn Thornton, RHIA, CCS HIM IMEducation & Compliance Manager Are you stymied by NCCI Edits? Do you really understand the meaning of modifier indicator (1) on the NCCI Procedure to Procedure (PTP) Edit Tables? What about the edit rationales? Are you able to navigate the tables and …
How Do You Know? Tips on Medical Record Abstraction I learned early in my career there really is an answer to virtually every question for abstracting in an approved resource manual.
Fourth Universal Definition of Myocardial Infarction (UDMI) CDI & Coding Considerations for Myocardial Injury Studies have shown that myocardial injury, defined by an elevated cardiac troponin (cTn) value, is frequently encountered clinically and is associated with an adverse prognosis.
Developing Outpatient Coding Education Lynn Thornton, RHIA, CCS HIM Education and Compliance Manager When developing education for HIM coders it is essential to look at the opportunity to including clinical, technical and regulatory guidance.
Simplifying Clinical Validation There are many definitions for clinical validation (CV), but in healthcare, clinical validation is ensuring clinical evidence exists in the medical record for all documented diagnoses/conditions.
Assigning codes for HIV / AIDS Assigning HIV/AIDS codes is a sensitive matter and can potentially have great impact on the patient’s life.