by Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, CHPS
The coding function would not exist if there were no physician documentation from which to code. The challenge for coders is not so much that there is no physician documentation; it’s that the documentation they have does not...Read More »
While many facilities have developed robust denial management teams and have implemented comprehensive procedures for submitting appeals, one of the more powerful strategies in reducing denials can be summed up with this well-known expression: Nip it in the bud.
by Glenn Krauss, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS
CDI specialists can increase their value to their hospital and ensure a far greater degree of physician buy-in through serving as a pro-active denials management specialist. In some respects CDI specialists already serve as a...Read More »
While CDI and coding staff members are well versed in assigning a principal diagnosis, they are often less adept at incorporating the concept of medical necessity into their practices, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS. Coders tend to simply code what'...Read More »
In the aggressive post-discharge auditing environment where I now find myself practicing medicine, I and my colleagues are subject to heavy scrutiny by CMS and private insurers. Observation versus inpatient status review is the new focus of these non-...Read More »
by Glenn Krauss, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS
Because most CMS local and national coverage determinations governing medical necessity and limitations of coverage center around outpatient procedures (e.g., lesion removals, cataract surgeries, and blepharoplasty repairs),...Read More »
