YESBLOG: HIM & CODING NEWS
The YES HIM Consulting blog provides medical coding news, updates, and resources for health information management and coding professionals. Subscribe to the YES HIM & Coding Insights Newsletter today.
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.
As a follow-up to our previous articles on the subject of Risk Adjustment and HCCs, we now review some scenarios of HCC chronic conditions and the importance of specificity in documentation and coding. Accurate and complete documentation of chronic condition diagnoses by clinicians is an essential component of the risk adjustment and the HCC process. It is also imperative that the documentation of a disease/condition be as specific as possible. Specificity can make a difference in the patient’s treatment plans, as well as accurate code assignments, which then leads to appropriate HCC assignment and payment.
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.”
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.
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).
Subscribe to the YES Insights Newsletter
