Hospitals have relied on a relatively manual process and retrospective audits for coding compliance, but new technology is streamlining the process, allowing providers to get ahead of denials.
Could your coding quality program use some work? Review best practices for creating an optimal program.
From my previous blogs, you know that I am a huge proponent of computer-assisted coding (CAC). Some of the key goals of CAC utilization are increased productivity, maximizing reimbursement and […]
Specialization and single-path coding are gaining traction, and both are important strategies for coding teams that need to streamline processes, maximize coder output and reduce costs. This eGuide provides strategies […]
I’ve been talking about this for years. I still see folks who don’t think compliance with medical necessity polices is critical. Believe me, I understand human nature; noncompliance can be […]
In late December 2017, I was asked by a colleague for my opinion on a customer’s inquiry about modifier 52 and its use in mammograms. CPT® modifier 52 represents a […]
In September 2017, Office of Inspector General (OIG) released a report titled “Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities.” […]
This article details how coders can enhance their careers by becoming proficient in the finer points of the latest payment methodologies.
Last fall, I wrote a blog on providers who continue to bill cost-sharing co-payments to “dually eligible” (Medicare/Medicaid) patients. This practice is not allowed; providers and suppliers are barred from […]
Donna Smith of 3M Consulting Services explores crucial oversight processes, audit techniques, escalation policies & 2017 ICD-10-CM guidelines.
Last year I wrote a blog about the new Medicare Outpatient Observation Notice or MOON, the latest in the CMS library of Beneficiary Notices. A lot of folks thought no […]
Donna: Hey Sue, have you read the WEDI document on the 2016 ICD-10-CM Clinical Indicators? This is another opinion on Guideline 19, which was published in the 2017 “ICD-10-CM Official […]