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hospital coding audits

Coding Audits: How Identifying Issues Sooner Rather than Later Saves Money for the Hospital/Facility

By YES HIM Consulting

The establishment of a coding compliance program remains a significant effort by the Office of the Inspector General (OIG) in its attempt to engage the healthcare community in combating fraud and abuse. The OIG developed a Compliance Resource Portal with materials and guidelines for healthcare professionals. A fundamental element to an effective compliance program is conducting internal monitoring and auditing. Coding audits have the added value of ensuring you are running an efficient and profitable, not to mention minimized liability, operation. Earlier detection of any potential coding issues will pay off financially and will reduce risks for additional external audits.

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facility acquisition process

Case Study: Coding Quality Improvement Plan for Healthcare Facility Acquisition Process of a Large Physician Group

By YES HIM Consulting

Healthcare facilities and independent practices face unique challenges when merging or being acquired. This case study provides a thorough analysis on the unique challenges a medical facility faces when merging with independent practices, as well as solutions for a successful facility acquisition process.

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Quality Payment Program

Updates Coming to the Quality Payment Program in 2020

By YES HIM Consulting

In the 2020 Medicare Physician Fee Schedule Final Rule released by the Centers for Medicare and Medicaid Services late last year, several changes were made to the value-based Quality Payment Program (QPP) to simplify the rules for providers. These updates will “impact more than 1 million clinicians eligible for one or both of the QPP’s two performance tracks, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs). CMS estimates that 880,000 clinicians will be MIPS-eligible in 2020, and between 210,000 and 270,000 clinicians will achieve Qualifying APM Participant (QP) status in 2020.”

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Gastrointestinal Procedures

Refresh With YES: PCS Gastrointestinal Procedures | 1 CEU

By YES HIM Consulting

YES HIM Consulting provides most up-to-date content with a practical approach compliant with latest HIM & coding guidelines. The ICD-10-PCS Refresh With YES webinar series provides refresher courses for coders and auditors. These courses offer a practical review to complex ICD-10-PCS topics, provided by our nationally recognized educators and our YES HIM Executive team. The Refresh With YES: PCS Gastrointestinal Procedures webinar consists of 14-19-minute modules that examine Gastrointestinal procedures, such as Lysis of Adhesions, GI Anatomy and Guidelines, Bowel Procedures, and Gastric Procedures.

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icd-10 code u07.1

CDC Releases Updated Coding & Reporting Guidelines For ICD-10 Code U07.1, COVID-19, Effective April 1 Through Sept 30

By Ann Zeisset

Previously the CDC/NCHS provided the ICD-10-CM Official Coding Guideline Supplement for 2019 Novel Coronavirus (COVID-19) coding, effective February 20, 2020. With the confirmation that the U07.1 code is implemented April 1, 2020, additions to the Official Coding and Reporting Guidelines were released to accompany the new code. These Guidelines appear in the Chapter 1 guidelines for Infectious Disease, and Chapter 15 for Pregnancy, Childbirth and the Puerperium, and are included in this article. The Official Coding and Reporting Guidelines are effective April 1, 2020, through September 30, 2020 (CDC/NCHS, 2020).

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