Hospital acquired conditions (HAC): The phrase seems simple enough to understand. These are conditions one acquires while in the hospital, right? Like most phrases included in the healthcare vernacular, however, discussion of HAC contains various levels of detail that can be difficult to...Read More »
The Centers for Disease Control (CDC) in March posted new 2011 guidelines for ICD-10-CM. There are relatively few changes to conventions, general coding guidelines, and chapter specific guidelines. Adjustments are easy to spot since...Read More »
Highlights from Coding Clinic, Third and Fourth Quarters 2010, include:
When a primary lung cancer metastasizes into another lobe of the lung, the second lesion should receive an additional code as a metastasis—not as a primary lesion. However, coders cannot
The ICD-9 Coordination and Maintenance Committee recently posted the March 9-10 Diagnosis Meeting Agenda. The agenda included a discussion of proposed ICD-9 diagnosis additions and revisions as well...Read More »
Recovery Audit Contractors (RAC) denied $86 million in claims in 2010—more than double the $42 million reported in the third quarter. Medically unnecessary services accounted for 57% of the denials, with 33% of these for short stay patients, according to the American Hospital Association’s (AHA...Read More »
Clarifying hospital-acquired conditions (HAC) and present-on-admission (POA) conditions represent just two additional aspects of medical record inspection CDI specialists are frequently asked to perform. Determining whether a condition was actually POA and not a HAC helps coders sequence...Read More »
The Department of Health and Human Services (HHS) called it the largest healthcare fraud sting in history. On February 17, the Medicare Fraud Strike Force charged 111 defendants in nine cities, including doctors, nurses, healthcare company owners and executives, and others, for alleged...Read More »