By Sheri Poe Bernard, CPC, COC, CCS-P I see a compliance fiasco waiting to happen in risk adjustment regarding tamoxifen and breast cancer coding. I was a minority of one regarding active breast cancer vs. history of breast cancer coding at a discussion during a recent HEALTHCON session, but I feel confident that I am ...
Mar 1st, 2013
By Anna Barnes, CPC, CEMC, CGSCS Consider patient history and reason for the visit for accurate diagnosis coding. The advent of the Affordable Care Act (ACA) has increased patient access to a greater number of preventative services. Physicians and patients have both benefited from this new law. Patient disease processes are being diagnosed at an ...
Aug 1st, 2012
By Serine A. Haugsness, CPC The concept of risk adjustment was “born” upon passage of the Balanced Budget Act of 1997 and refined by the Beneficiary Improvement Act of 2000, which mandated that the Centers for Medicare & Medicaid Services (CMS) implement risk adjustment for Medicare Advantage organizations (MAOs) in 2004 and achieve 100 percent ...