Coding Elevated, White Paper – November 2016
Coding Quality in the Crosshairs.
Reports of ICD-10 coding quality range from extremely low to on par with ICD-9 benchmarks. As healthcare organizations enter the second year of ICD-10, vigilant HIM, clinical documentation and revenue cycle executives remain watchful for claims denials due to inaccurate or nonspecific coding.
The conclusion co CMS’s one year grace period for code specificity also adds a new layer of concern as organizations brace for denials by performing more coding audits and documentation reviews. Along this journey, four new best practices for coding and documentation audits have emerged:
- Conduct frequent internal reviews and quarterly external coding audits to identify and address any coding accuracy issues.
- Combine coding audits with clinical documentation reviews since clinical validation is a frequent reason for payment denials.
- Extend reviews beyond DRG assignment to include clinical validation–clinical indicators must also support the DRG.
- Apply data mining and analytics to coded data to target corrective action.
Read more by downloading our White Paper below: