To assign an appropriate diagnosis related group (DRG), you must correctly identify present on admission (POA) indicators on all inpatient claims for services rendered in general acute care hospitals. This may be challenging if there are documentation deficiencies in the medical record. Here’s how to remedy those deficiencies. POA Review POA is defined as conditions ...
In Audit
Dec 16th, 2016
In inpatient auditing, you are auditing ICD-10-CM diagnosis codes, ICD-10-PCS procedures codes, and much more. The purpose of inpatient auditing is to ensure that the correct DRG was assigned. All of the following factors play a role in making sure the correct inpatient reimbursement is received: 1. Assignment of the principal diagnosis – If you ...
Mar 1st, 2013
By Dorothy Steed, CPA, CPC-H, CPC-I, CEMC, CFPC, CPMA, CHCC, CPUM, CPUR, CPHM, CCS-P, RCC, RMC Be ready if a hospital employment opportunity arises in a facility near you. In our changing health care environment, there may come a time when you need to look beyond your physician practice and branch out in another direction. For ...
May 1st, 2012
With a trend moving toward hospital care, consider chargemaster basics. By Dorothy Steed, CPA, CPC-H, CPC-I, CEMC, CFPC, CPMA, CHCC, CPUM, CPUR, CPHM, CCS-P, ACS-OP, RCC, RMC As more physicians head under the hospital umbrella to furnish cost-effective care, opportunities are opening for coders in the facility environment. Your doctor may be considering a move ...
Mar 1st, 2011
Ensure billing staff members are diligent and adequately skilled in claims administration. By Dorothy Steed, CPC-H, CHCC, CPC-I, CEMC, CFPC, CPMA, CPUM, CPUR, CPHM, CCS-P, ACS-OP, RCC, RMC, PCS, FCS, CPAR The purpose of facility billing is to submit timely, clean claims to the payer; but the processes that go into filing in a facility ...