In my work with clients, I often identify potential coding issues around the frequency of evaluation and management (E/M) visits compared to a benchmark. For example, based on Medicare distribution data, Chart 1 illustrates possible over-coding (relative to 46 percent level 3 and 53 percent level 4 visits) and under-coding (relative to 0 percent level ...
Value-based care models rely heavily on provider documentation to illustrate clinical quality as the basis for reimbursement. The Certified Documentation Expert Outpatient (CDEO®) credential is an excellent way for coding professionals to validate their essential role in documentation improvement to practices, hospital systems, and payers. Although AAPC designates the credentialed title as “Certif...
In Coding
Jun 2nd, 2016
Healthcare is quickly transforming from a fee-for-service payment model where providers are paid based on volume of services to various quality-based payment methodologies. These new payment systems are focused on promoting quality of care and creating better outcomes. One of these new payment methodologies is risk adjustment. The goal of risk adjustment is to reward ...