Q:We’ve encountered audit takebacks and denials from a certain payer who removed codes and procedures that result in lower DRGs. Do you have any advice for fighting or preventing these types of denials?Read More »
Q: Our coders often select the principal diagnosis based on how invasive the testing is. For example, a patient comes in with vertigo and hematemesis. For the vertigo, the physician orders a brain CT, IV medications, and an ear, nose, and throat consult. The patient is diagnosed...Read More »
Q:If the patient comes in with a high blood alcohol level and the provider documents that number in their note, do they also need to specifically write “patient with intoxication?”Read More »
I love the show MythBusters, even though there are times I just can’t believe their conclusions. For example, I raised my kids believing the infamous five-second rule, and they seemed to have survived quite well...Read More »
Q: I need some help understanding severity of illness (SOI) and risk of mortality (ROM) as it’s my first encounter with APR-DRG factors that may affect reimbursement. First, how does one measure the SOI and ROM? Could you elaborate on how complications or comorbidities (CC) and major CCs...Read More »
